ORIGINAL ARTICLE Racial differences in the burden of coronary artery calcium and carotid intima media thickness between Blacks and Whites

# The Author(s) 2014. This article is published with open access at Springerlink.com Background Identification of racial differences in the burden and correlates of carotid intima media thickness (CIMT) and coronary artery calcium (CAC) may provide the basis for the development of race-specific cardiovascular disease (CVD) risk prediction algorithms. Methods In the Heart Strategies Concentrating on Risk Eval-uation (Heart SCORE) study, CIMTwas measured by carotid ultrasonography in 792 individuals (35 % Black). CIMT>1 mm was considered significant. CAC was quantified by electron beam computed tomography in 776 individuals (46 % Black). CACwas considered significant if the Agatston score was>100. Cross-sectional associations between race, CIMT and CAC were assessed using logistic regression models. Results Blacks had greater CIMT (mean difference 0.033 mm, 95 % CI 0.005–0.06 mm; p=0.02) and 1.5-fold (95 % CI 1.0–2.3) higher odds of having significant CIMT than Whites. Blacks had less CAC than Whites (mean Agatston score difference 66, [11–122]; p=0.02) and 50 % lower odds of a significant CAC score compared with Whites (0.5 [0.3–0.7]). These associations were virtually unchanged after adjustment for CVD risk factors. Of the novel CVD risk markers assessed, small-dense low-density lipoprotein was independently associated with increased odds of significant CIMT, with the association being similar among Blacks and Whites (odds ratio [95 % CI]: 1.7 [1.2–2.5] and 1.4 [1.0–1.8] per 1-SD higher level, respectively). Interleukin-6 was signif-icantly associated with CAC among Blacks (1.4 [1.0–2.0]). Conclusion Black race is independently associated with greater CIMT but less CAC than White race. CVD risk stratification strategies that incorporate these measures of subclinical atherosclerosis should consider race-specific algorithms