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Abdominal aortic calcific deposits are associated with increased risk for congestive heart failure: the Framingham

Craig R Walsh1, L Adrienne Cupples, Daniel Levy

  • 1Framingham Heart Study, Framingham, Mass 01702, USA.

American Heart Journal
|October 3, 2002
PubMed

Insights

Atherosclerosis in the abdominal aorta, detected via calcific deposits on X-rays, significantly increases the risk of congestive heart failure (CHF) in both men and women. This finding is independent of coronary heart disease (CHD), highlighting a new risk factor for CHF.

Area of Science:

  • Cardiology
  • Radiology
  • Public Health

Background:

  • Limited prospective data exist on the association between extracoronary atherosclerosis and congestive heart failure (CHF).
  • Coronary heart disease (CHD) is extensively studied in relation to CHF, but other atherosclerotic locations are less understood.

Purpose of the Study:

  • To determine the association between aortic atherosclerosis, identified by calcific deposits in the abdominal aorta on lateral lumbar radiographs, and the risk of developing congestive heart failure (CHF).

Main Methods:

  • Utilized lateral lumbar radiographs from 2467 participants of the Framingham Heart Study, initially free of CHF.
  • Calculated an abdominal aortic calcium (AAC) score based on the extent of aortic calcification.
  • Employed proportional hazards models to analyze the relationship between AAC score and CHF risk.

Main Results:

  • Increased risk of CHF was observed in men and women across higher tertiles of AAC score compared to the lowest.
  • In men, the hazards ratio (HR) for CHF was 2.2 (95% CI 1.3-3.7) for the third tertile.
  • In women, the HR for CHF was 3.2 (95% CI 2.0-5.1) for the third tertile, even after adjusting for prior CHD.

Conclusions:

  • Abdominal aortic atherosclerosis is a significant, independent risk factor for congestive heart failure (CHF).
  • Noninvasive detection of abdominal aortic calcium (AAC) can identify individuals at high risk for CHF.
  • Further research into the link between AAC and vascular compliance is warranted for CHF prevention strategies.
Abstract

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