Mamudu Hadii M, Paul Timir K, Wang Liang, Veeranki Sreenivas P, Panchal Hemang B, Alamian Arsham, Sarnosky Kamrie, Budoff Matthew
Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, P.O. Box 70264, Johnson City, TN, United States.
Division of Cardiology, James. H. Quillen College of Medicine, East Tennessee State University, 329 N State of Franklin Rd, Johnson City, TN 37604, United States.
Prev Med. 2016 Jul;88:140-6. doi: 10.1016/j.ypmed.2016.04.003. Epub 2016 Apr 14.
The risk factors for cardiovascular disease (CVD) are associated with coronary atherosclerosis and having multiple risk factors potentiates atherosclerosis. This study examined the prevalence of multiple biological and lifestyle/behavioral risk factors and their association with coronary artery calcium (CAC), a marker for subclinical coronary atherosclerosis.
This is a cross-sectional study of 1607 community-dwelling asymptomatic individuals from central Appalachia who participated in CAC screening between January 2011 and December 2012. Data on demographics (sex and age) and 7 traditional risk factors for coronary artery disease (CAD) were collected and categorized into 5 groups (0-1, 2, 3, 4, and ≥5). Prevalence of these risk factors and CAC scores (0, 1-99, 100-399, ≥400) were assessed, and the impact of the number of risk factors on CAC scores were delineated using multiple logistic regression.
Over 98% of participants had ≥1 risk factor. While obesity, diabetes, hypertension, and family history of CAD significantly increased the odds of having CAC, CAC scores significantly increased with number of risk factors. After adjusting for demographic factors, having 3, 4, and ≥5 risk factors was significantly associated with increased odds of having higher CAC scores when compared to zero CAC score by more than one and half times [OR=1.65, CI (1.20-2.25)], two times [OR=2.32, CI (1.67-3.23)] and three times [OR=3.45, CI (2.42-4.92)], respectively.
The high prevalence of multiple risk factors in the study population suggests the need for aggressive multiple risk factors interventions for primary prevention of CAD, which could address CVD health disparities.
心血管疾病（CVD）的危险因素与冠状动脉粥样硬化相关，且存在多种危险因素会加剧动脉粥样硬化。本研究调查了多种生物学和生活方式/行为危险因素的患病率及其与冠状动脉钙化（CAC）的关联，冠状动脉钙化是亚临床冠状动脉粥样硬化的一个标志物。
这是一项横断面研究，研究对象为来自阿巴拉契亚中部地区的1607名无症状社区居民，他们于2011年1月至2012年12月期间参与了CAC筛查。收集了人口统计学数据（性别和年龄）以及7种传统的冠状动脉疾病（CAD）危险因素，并将其分为5组（0 - 1、2、3、4和≥5）。评估了这些危险因素的患病率和CAC评分（0、1 - 99、100 - 399、≥400），并使用多元逻辑回归分析了危险因素数量对CAC评分的影响。
超过98%的参与者有≥1种危险因素。虽然肥胖、糖尿病、高血压和CAD家族史显著增加了患CAC的几率，但CAC评分随着危险因素数量的增加而显著升高。在调整了人口统计学因素后，与CAC评分为零相比，有3种、4种和≥5种危险因素时，患较高CAC评分的几率分别显著增加了超过1.5倍[OR = 1.65，CI（1.20 - 2.25）]、2倍[OR = 2.32，CI（1.67 - 3.23）]和3倍[OR = 3.45，CI（2.42 - 4.92）]。
研究人群中多种危险因素的高患病率表明，需要积极采取多种危险因素干预措施来进行CAD的一级预防，这可能有助于解决CVD健康差异问题。
