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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2002;22:359.)
© 2002 American Heart Association, Inc.

Editorials

Coronary Calcium, Race, and Genes

Teri A. Manolio; Diane E. Bild

From the Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute, Bethesda, Md.

Correspondence to Teri A. Manolio, MD, PhD, National Heart, Lung, and Blood Institute, Division of Epidemiology, Bethesda, MD 20892-7934.

Measurement of coronary calcium has become a useful tool in the investigation of coronary disease and coronary risk, as evidenced by the companion articles in this issue examining the relationship of race and genetic factors to coronary calcium.^1,2 Newman et al¹ report racial differences in coronary calcium measures in older adults participating in the Cardiovascular Health Study. Among 471 white and 143 black participants with an average age of 80 years, median coronary calcium scores were lower in blacks than in whites, particularly in men, even after adjustment for other black-white differences. Black men were only 20% as likely, and black women 71% as likely, as whites to have increased calcium scores. In the small subgroup of participants with myocardial infarction, who might be expected to be more similar, calcium scores still were lower among blacks than whites.

See pages 418 and 424

This is not the first study to demonstrate racial differences in coronary calcium prevalence; Tang et al³ reported lower calcium prevalence in the 87 black participants of the largely self-referred South Bay Heart Watch. Interestingly, short-term follow-up of that cohort showed blacks to have higher risk of clinical coronary events despite their lower scores,⁴ raising the question of whether the relationship of calcium to subsequent events differs by race. Another small study of young adults did not identify but did not exclude the possibility of racial differences in coronary calcium.⁵

These findings may cause us to question the premise that coronary calcium and clinically overt coronary disease . . . [Full Text of this Article]