Key result
Over a 14-year interval, arterial calcification volumes increased considerably across multiple vascular beds, with hypertension being most consistently associated with calcification progression.
Why the study?
Information on the development of arteriosclerosis over time is lacking.
Cohort (n=807)
Yes
Arterial calcification progresses significantly over 14 years with sex- and artery-specific patterns, indicating that assessing a single arterial bed may not fully capture systemic arteriosclerosis.
Arterial calcification progresses substantially over 14 years across beds; leaves open whether targeted risk-factor control slows trajectories in older adults.
OBJECTIVES: There is a lack of information on the development of arteriosclerosis over time. This study aims to assess long-term sex-specific changes in arterial calcifications in five arteries, and the influence of cardiovascular risk factors hereon. METHODS: From a population-based cohort, 807 participants (mean baseline age, 65.8; SD, 4.2) underwent a non-contrast computed tomography (CT) examination between 2003 and 2006, and after a median follow-up of 14 years. We assessed incidences and changes in volumes of coronary artery calcification (CAC), aortic arch calcification (AAC), extracranial (ECAC) and intracranial carotid artery calcification (ICAC), and vertebrobasilar artery calcification (VBAC). We investigated the simultaneous presence of severe progression (upper quartile of percentual change volumes). Associations of cardiovascular risk factors with changes in calcification volumes were assessed using multivariate linear regression models. RESULTS: ) increased from of 129 to 916 in men and from 93 to 839 in women. For VBAC, no change in volumes was observed though more than a quarter of participants without baseline VBAC developed VBAC during follow-up. Severe progression was most often observed in only one artery at the same time. Hypertension was most consistently associated with increase in calcifications. Associations of diabetes, hypercholesterolemia, and smoking with changes in calcifications varied across arteries and sex. CONCLUSIONS: We found a considerable incidence and increase in volumes of calcifications in different arteries, over a 14-year time interval. Cardiovascular risk factors were associated with increase of calcifications with sex-specific differential effects across arteries. CLINICAL RELEVANCE STATEMENT: There is a considerable incidence and increase in volumes of calcifications in different arteries, over a 14-year time interval. Cardiovascular risk factors are associated with increase of calcifications with sex-specific differential effects across arteries; thus, assessing changes in only one artery may thus not provide a good reflection of the systemic development of arteriosclerosis. KEY POINTS: • Assessing change in arterial calcification in only one artery does not reflect the systemic development of arterial calcification. • Cardiovascular risk factors are associated with progression of arterial calcifications. • Progression of arterial calcification is sex and artery-specific.
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Toorn et al. (2024) conducted a cohort in Arterial calcifications (n=807). Cardiovascular risk factors vs. Absence of risk factors was evaluated on Incidence and change in volumes of arterial calcifications. Over a 14-year interval, arterial calcification volumes increased considerably across multiple vascular beds, with hypertension being most consistently associated with calcification progression.
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