The association between epicardial fat thickness and coronary artery calcification according to blood pressure status in nonhypertensive individuals: From the CAESAR study

Abstract

Epicardial adipose tissue represents visceral adiposity, and the coronary artery calcium (CAC) score (CACS) has been suggested as a reasonable surrogate for coronary atherosclerosis. Epicardial fat thickness (EFT) and blood pressure status can be attributed to coronary artery calcification. The present study was performed to evaluate the association between EFT and coronary artery calcification according to blood pressure status in nonhypertensive individuals. The CACS and echocardiographic EFT measurement were performed in a total of 1878 nonhypertensive individuals (1535 men; mean age, 44±8.3years). Subjects were divided into quartiles according to EFT (≤2.575, 2.576-3.168, 3.169-3.900, and >3.900mm) and into 2 groups according to the presence of CAC. Additionally, individuals were classified as normotensive (n=1064) or prehypertensive (n=814). The prevalence of CACS >0 group in prehypertensive individuals was 6.1%, 18.1%, 22.6%, and 29.9% in the lowest, second, third, and highest EFT quartiles, respectively (P<.001) and 7.3%, 13.1%, 14.0%, and 13.9% in the normotensive group (P=.050). On multivariate regression analysis, the second, third, and highest quartile EFT groups had higher odds ratios for the presence of CAC than that of the lowest quartile (odds ratio [95% confidence interval], 3.849 [1.215-12.194], 4.069 [1.235-13.412], and 4.383 [1.385-13.875], respectively), although only in prehypertensive individuals. Moreover, an increased absolute EFT level was also associated with increased CACS in prehypertensive individuals (standardized β=0.101, P=.035). This study showed an independent relationship between EFT and coronary artery calcification in nonhypertensive individuals, with variable differences in this association according to blood pressure status.