Evidence map›Paper›PMID 40471761›Full record

ArticleJACC. Cardiovascular imaging2025

Mid- to Late-Life Traditional Cardiovascular Risk Factor Exposure and Zero Coronary Artery Calcium: The ARIC (Atherosclerosis Risk in Communities) Study.

Frances M Wang, Shoshana H Ballew, Aaron R Folsom, Lynne E Wagenknecht, Candace M Howard, Josef Coresh, Matthew J Budoff, Michael J Blaha, Kunihiro Matsushita

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. Cardiovascular imaging, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Frances M WangJohns Hopkins University, Baltimore, Maryland, USA.
Shoshana H BallewJohns Hopkins University, Baltimore, Maryland, USA; Optimal Aging Institute, New York University Grossman School of Medicine, New York, New York, USA; Departments of Population Health and Medicine, New York University Grossman School of Medicine, New York, New York, USA.
Aaron R FolsomUniversity of Minnesota School of Public Health, Minneapolis, Minnesota, USA.
Lynne E WagenknechtWake Forest University, Winston-Salem, North Carolina, USA.
Candace M HowardUniversity of Mississippi Medical Center, Jackson, Mississippi, USA.
Josef CoreshJohns Hopkins University, Baltimore, Maryland, USA; Optimal Aging Institute, New York University Grossman School of Medicine, New York, New York, USA; Departments of Population Health and Medicine, New York University Grossman School of Medicine, New York, New York, USA.
Matthew J BudoffLundquist Institute at Harbor-UCLA Medical Center, Torrance, California, USA.
Michael J BlahaJohns Hopkins University, Baltimore, Maryland, USA.
Kunihiro MatsushitaJohns Hopkins University, Baltimore, Maryland, USA. Electronic address: kuni.matsushita@jhu.edu.

Funding

CARDIOVASCULAR EPIDEMIOLOGY INSTITUTIONAL TRAININGT32HL007024 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI Elizabeth Selvin · 1985 to 2026
$17.5M
Quantifying cardiovascular calcification at very old age for personalized risk classificationR01HL136592 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI BLAHA, MICHAEL J, MATSUSHITA, KUNIHIRO · 2017 to 2021
$3.7M
Coronary Artery Calcium, Aortic Calcification and Density in MESAR01HL146666 · NHLBI · LUNDQUIST INSTITUTE FOR BIOMEDICAL INNOVATION AT HARBOR-UCLA MEDICAL CENTER · PI BUDOFF, MATTHEW J · 2020 to 2023
$3.0M
NHLBI NIH HHS HHSN268201700001CNHLBI NIH HHS HHSN268201700001INHLBI NIH HHS HHSN268201700002CNHLBI NIH HHS HHSN268201700002INHLBI NIH HHS HHSN268201700003CNHLBI NIH HHS HHSN268201700003INHLBI NIH HHS HHSN268201700004CNHLBI NIH HHS HHSN268201700004INHLBI NIH HHS HHSN268201700005CNHLBI NIH HHS HHSN268201700005INHLBI NIH HHS R01 HL136592NHLBI NIH HHS R01 HL146666NHLBI NIH HHS T32 HL007024
6 · The paper itself

Abstract

backgroundOur understanding of traditional atherosclerotic risk factors is based predominantly on one-time measurements and associations with adverse cardiovascular outcomes.

objectivesThe aim of this study was to evaluate the contribution of mid- to late-life cumulative risk factor exposure to healthy arterial aging, represented by a persistent coronary artery calcium (CAC) score of zero.

methodsAmong 2,044 community-dwelling, participants free of coronary heart disease from the ARIC (Atherosclerosis Risk in Communities) study, the associations of ∼30-year time-weighted average mid- to late-life (starting at a median age of 49 years in 1987-1989) traditional atherosclerotic risk factors (cholesterol, systolic blood pressure, fasting glucose, and smoking) with late-life (median age 80 years in 2018-2019) CAC 0 were evaluated.

resultsA total of 204 participants (10.0%) had CAC 0, and they tended to have more favorable mid- to late-life average risk factor profiles than those with CAC: lower total cholesterol, especially <160 mg/dL; lower systolic blood pressure, especially <125 mm Hg; and higher high-density lipoprotein cholesterol, especially >45 mg/dL. The association was less evident for fasting glucose, with no increased probability of CAC 0 at <95 mg/dL. Never smoking was associated with a 5.7 (95% CI: 2.3-16.7) times greater odds of CAC 0 vs smoking throughout mid- to late-life. Within sex-race groups, average modifiable risk factors predicted substantial differences in CAC 0 probability (eg, for a Black woman, 53% vs 0.4% for a low vs high risk factor profile, respectively).

conclusionsFavorable average risk factor profiles at mid- to late-life were associated with a greater probability of CAC 0 at older age. These results highlight the importance of maintaining a healthy risk factor profile from mid- to late-life, with implications for public health promotion and policy.

Indexed as

Coronary Artery DiseaseVascular CalcificationAgedAged, 80 and overAge FactorsBiomarkersBlood GlucoseBlood PressureCoronary AngiographyFemaleHeart Disease Risk FactorsHumansMaleMiddle AgedPredictive Value of TestsProspective StudiesBiomarkersBlood Glucosecoronary artery calcificationhealthy aginglife-course preventionsubclinical atherosclerosis

Identifiers

PMID40471761
PMCPMC12354040

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.