New findings suggest mammograms may help predict cardiovascular disease

May 25 2004

The presence of breast vascular calcifications found through common mammograms is associated with an increased risk of cardiovascular diseases in women, according to an article in the May Journal of Women's Health. In "Breast Vascular Calcification and Risk of Coronary Heart Disease, Stroke and Heart Failure," researchers at the Kaiser Permanente Northern California Division of Research state that they have found a modest but significant association between breast vascular calcification and risk of coronary heart disease, stroke and heart failure.

Calcium deposits in the wall of arteries signify the presence of atherosclerosis, the cholesterol deposits implicated in heart attack and stroke. Carlos Iribarren, M.D., MPH, Ph.D., research scientist at the Division of Research, Kaiser Permanente, Northern California and the lead author of the article, said: "More research is needed to clarify how useful finding breast arterial calcifications may be for cardiovascular risk assessment; however mammograms might represent a unique opportunity since millions are done in the United States every year."

"When vascular calcifications are found in a mammogram, particularly if they are extensive, patients and clinicians should interpret this finding in the context of other cardiovascular risk factors such as high blood cholesterol, hypertension and elevated blood glucose (the hallmark of diabetes)," Iribarren said. For example, a woman who doesn't know her blood glucose or cholesterol level and whose mammogram shows vascular calcifications should undergo routine testing for these factors.

The overall cardiovascular profile, and not the mammogram alone, should then dictate the need for further diagnostic tests such as treadmill tests or myocardial perfusion scans. "The presence of breast vascular calcifications may also represent an incentive toward a heart-healthy diet, avoidance of smoking and engagement in more physical activity," Iribarren said.

The study cohort consisted of 12,761 female patients of Kaiser Permanente Northern California, aged 40 to 79 years, who attended voluntary multiphasic health checkups at the KP Oakland Medical Center between 1968 and 1973. Researchers compared the results of the mammograms with the discharge diagnoses of these women from hospitalizations from 1971 to 2000, and with the causes of death shown in the California Automated Mortality Linkage System (CAMLIS). Kaiser Permanente is America's leading integrated health care program.

Founded in 1945, it is a non-profit, multi-specialty, group-practice prepayment program serving the health care needs of 8.3 million members in nine states and the District of Columbia. The Kaiser Permanente Northern California Region has almost 3.2 million members. It includes 5,000 physicians in The Permanente Medical Group (TPMG) and about 54,000 employees.

Research conducted by scientists at the Kaiser Permanente Division of Research in Oakland, Calif. has appeared in the Journal of the American Medical Association, the New England Journal of Medicine, Pediatrics, the American Journal of Preventive Medicine and numerous other peer-reviewed medical journals. CONTACT: Kathleen Barco of Kaiser Permanente, 510-987-3900. http://www.kaiserpermanente.org