Coronary artery calcium (CAC) score may be better than age for predicting coronary heart disease in older adults, a meta-analysis of population-based studies showed.
CAC score had a higher C statistic for incident coronary heart disease than did age (0.733 versus 0.690) and modestly so for incident stroke too during 11 years of follow-up (0.695 versus 0.670). Replacing age with CAC score in predictive models based on traditional cardiovascular risk factors also improved discrimination for incident coronary heart disease.
“Whether CAC score can assist in guiding the decision to initiate statin treatment for primary prevention in older adults requires further investigation,” the researchers concluded in JAMA Cardiology.
Calcium Genes Linked With Heart Disease
Genetic predisposition to higher serum calcium levels is potentially causally related to higher risk of coronary artery disease (CAD) and myocardial infarction (MI), a mendelian randomization study reported in the Journal of the American Medical Association.
Each standard deviation higher serum calcium level predicted by six single-nucleotide polymorphisms (related only to serum calcium levels without potential confounders) was associated with odds ratios of 1.25 for CAD and 1.24 for MI, both statistically significant.
“The finding from this study corroborates results from several observational studies showing a positive association of serum calcium levels with risk of cardiovascular disease,” the researchers wrote. But, they cautioned, “Whether the risk of CAD associated with lifelong genetic exposure to increased serum calcium levels can be translated to a risk associated with short-term to medium-term calcium supplementation is unknown.”
Earlier Orthostatic HTN Measurement
Earlier measurement of blood pressure may catch more risky orthostatic hypertension, analysis of the prospective Atherosclerosis Risk in…