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Elevated Serum Calcium Linked to Increased Carotid-Artery Plaque Thickness: Presented at ANA

By Paula Moyer

SAN FRANCISCO, CA -- November 4, 2003 -- People with elevations of serum calcium also have thicker carotid-artery plaques, and therefore may be at greater risk of a stroke, according to findings presented here on October 20^th at the 128^th Annual Meeting of the American Neurological Association.

"This finding is important, because the risk of myocardial infarction…increases 5-fold within 5 years for every 0.16 mm of carotid-wall thickness," said principal investigator Tanja Rundek, MD, PhD. "We need to think of non-stenotic plaques as a risk factor for stroke, and to see that elevated serum calcium promotes the formation of these plaques," she added.

Dr. Rundek is assistant professor of neurology, Columbia University College of Physicians and Surgeons in New York, United States, and the recipient of the Hazel K. Goddess Foundation for Stroke Research.

Dr. Rundek and her co-investigators wanted to conduct the study because of the concern that such plaques are not benign, and because of their interest in the role that accumulated calcium plays in plaque formation and calcification. The researchers wanted to know whether elevated serum calcium could serve as a marker for carotid-artery plaque thickness.

The team recruited a sample of 1,350 participants in the Northern Manhattan Study, who then underwent high-resolution B-mode carotid ultrasound. The investigators went on to obtain the participants' serum-calcium levels. The participants were an average of 67 years old; 59% were women. Fifty-five percent of the participants were Hispanic; 23% were African American, and 22% were white.

The subjects' average and median serum calcium was 9.10 mg/dl. The lowest quartile's serum calcium level was 8.80 mg/dl; the third highest was had an average of 9.40 mg/dl, and the 99^th percentile was 10.20 mg/dl.

The mean maximal carotid-plaque thickness was 0.95 mm. When the investigators conducted a multivariate regression analysis, they found that each unit increase in serum calcium was significantly associated with a mean increase in maximal carotid-plaque thickness (P=0.022). This significance held after the investigators had adjusted for several demographic and health factors. The demographic factors included the following: age, sex, race and education. Health factors included the following: blood pressure, cardiac disease, serum creatinine, cholesterol, diabetes and smoking status.

These findings should concern physicians, noted Dr. Rundek, because they imply that elevated serum calcium levels are associated with subclinical atherosclerosis, which is itself predictive of stroke risk. Dr. Rundek and her co-investigators hope, however, that balanced calcium metabolism may prove to be an appropriate therapeutic target for stroke prevention.

Dr. Rundek said that, in future research, she and her investigative team will seek to determine how serum calcium relates to calcium deposits within carotid plaques.


[Study Title: Serum Calcium is Associated with Carotid Artery Plaque Thickness: The Northern Manhattan Study: Abstract 8]

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