Objective: To examine the association between aortic arch calcification (AAC) and vascular disease in an older Chinese sample. Methods: For this study, 30,203 Chinese aged 50–85 years were recruited with baseline information on socioeconomic position, lifestyle and vascular risk factors. The presence and severity of AAC were diagnosed independently from chest X-ray by two radiologists. Results: The age-adjusted prevalence of AAC was significantly higher in women than men [34.6% (95% CI 33.9–35.3) vs. 27.9% (95% CI 26.8–28.8), p < 0.001]. Severity of AAC was significantly associated with physician-diagnosed ischemic heart disease (adjusted OR = 1.55, 95% CI 1.35–1.79) and combined vascular disease (OR = 1.48, 95% CI 1.30–1.69) after adjusting for multiple potential confounders. Increasing severity of AAC was associated with increased risk for ischemic heart disease and vascular disease (p for trend = 0.02 to <0.001). No association between AAC and stroke was found. Conclusions: AAC was strongly and independently associated with vascular disease, suggesting that assessment of AAC from chest X-ray, which is noninvasive and relatively inexpensive, can provide useful information for risk stratification of vascular disease, and should be routinely incorporated in chest X-ray examination.

1.
Iribarren C, Sidney S, Sternfeld B, Browner WS: Calcification of the aortic arch: risk factors and association with coronary heart disease, stroke, and peripheral vascular disease. JAMA 2000;283:2810–2815.
2.
Iijima K, Hashimoto H, Hashimoto M, et al: Aortic arch calcification detectable on chest X-ray is a strong independent predictor of cardiovascular events beyond traditional risk factors. Atherosclerosis 2010;210:137–144.
3.
Wexler L, Brundage B, Crouse J, et al: Coronary artery calcification: pathophysiology, epidemiology, imaging methods, and clinical implications. A statement for health professionals from the American Heart Association. Writing Group. Circulation 1996;94:1175–1192.
4.
Rumberger JA, Simons DB, Fitzpatrick LA, Sheedy PF, Schwartz RS: Coronary artery calcium area by electron-beam computed tomography and coronary atherosclerotic plaque area. A histopathologic correlative study. Circulation 1995;92:2157–2162.
5.
Sutandar W: Vascular calcification of the aortic arch and peripheral artery in haemodialysis patients with and without diabetes mellitus. Acta Med Indones 2008;40:181–186.
6.
Papanas N, Symeonidis G, Maltezos E, et al: Evaluation of aortic arch calcification in type 2 diabetic patients. Vasa 2005;34:113–117.
7.
Fabbian F, Catalano C, Orlandi V, Conte MM, Lupo A, Catizone L: Evaluation of aortic arch calcification in hemodialysis patients. J Nephrol 2005;18:289–293.
8.
Hashimoto H, Iijima K, Hashimoto M, et al: Validity and usefulness of aortic arch calcification in chest X-ray. J Atheroscler Thromb 2009;16:256–264.
9.
Fujiu A, Ogawa T, Matsuda N, Ando Y, Nitta K: Aortic arch calcification and arterial stiffness are independent factors for diastolic left ventricular dysfunction in chronic hemodialysis patients. Circ J 2008;72:1768–1772.
10.
Ogawa T, Ishida H, Akamatsu M, et al: Progression of aortic arch calcification and all-cause and cardiovascular mortality in chronic hemodialysis patients. Int Urol Nephrol 2010;42:187–194.
11.
Zhou HL, Jiang CQ, Lam TH, et al: Impact on calcification of aortic arch by lifestyle-related, physiologic and biochemical factors. Zhonghua Liu Xing Bing Xue Za Zhi 2009;30:776–779.
12.
Xu L, Jiang CQ, Lam TH, Thomas GN, Zhang WS, Cheng KK: Passive smoking and aortic arch calcification in older Chinese never smokers: the Guangzhou Biobank Cohort Study. Int J Cardiol 2009, Epub ahead of print.
13.
Jiang CQ, Lao XQ, Yin P, et al: Smoking, smoking cessation and aortic arch calcification in older Chinese: the Guangzhou Biobank Cohort Study. Atherosclerosis 2009;202:529–534.
14.
Jiang CQ, Lam T, Cheng K, et al: The prevalence and characteristics of aortic arch calcification among middle and elderly population in Guangzhou. Zhonghua Liu Xing Bing Xue Za Zhi 2007;28:173–176.
15.
Jiang C, Thomas GN, Lam TH, et al: Cohort profile: the Guangzhou Biobank Cohort Study, a Guangzhou-Hong Kong-Birmingham collaboration. Int J Epidemiol 2006;35:844–852.
16.
Yin P, Jiang CQ, Cheng KK, et al: Passive smoking exposure and risk of COPD among adults in China: the Guangzhou Biobank Cohort Study. Lancet 2007;370:751–757.
17.
Deng HB, Macfarlane DJ, Thomas GN, et al: Reliability and validity of the IPAQ-Chinese: the Guangzhou Biobank Cohort study. Med Sci Sports Exerc 2008;40:303–307.
18.
Li J, Galvin HK, Johnson SC, Langston CS, Sclamberg J, Preston CA: Aortic calcification on plain chest radiography increases risk for coronary artery disease. Chest 2002;121:1468–1471.
19.
Odink AE, van der Lugt A, Hofman A, et al: Association between calcification in the coronary arteries, aortic arch and carotid arteries: the Rotterdam study. Atherosclerosis 2007;193:408–413.
20.
Safar ME, Levy BI, Struijker-Boudier H: Current perspectives on arterial stiffness and pulse pressure in hypertension and cardiovascular diseases. Circulation 2003;107:2864–2869.
21.
Speer MY, Giachelli CM: Regulation of cardiovascular calcification. Cardiovasc Pathol 2004;13:63–70.
22.
Franklin SS, Gustin Wt, Wong ND, et al: Hemodynamic patterns of age-related changes in blood pressure. The Framingham Heart Study. Circulation 1997;96:308–315.
23.
Coats AJ: Ethical authorship and publishing. Int J Cardiol 2009;131:149–150.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.