Prevalences of mitral annular calcium (MAC), osteoporosis, and coronary artery disease (CAD) increase with aging and. often usually coexist. Correlates of MAC including cardiovascular risk factors and bone mineral density (BMD) have never been evaluated in men and women undergoing coronary angiography. Accordingly, we assessed the association between cardiovascular risk factors, BMD, and MAC in patients undergoing coronary angiography. The study population consisted of 484 consecutive patients (180 women, mean 60 10 years of age; 304 men, mean 60 10 years of age) who underwent coronary angiography. Complete transthoracic. echocardiographic studies were performed in all patients. Diagnosis of MAC was made by M-mode and cross-sectional transthoracic echocardiography. All patients were referred to the nuclear medicine department to measure BMD (T score) using dual-energy x-ray absorptiometry. The following clinical and demographic parameters were recorded: age, gender, body mass index, hypertension, diabetes mellitus, CAD, hypercholesterolemia, and smoking status. Prevalence of MAC in our study population was 20%. There were no statistically significant differences between groups with respect to body mass index, diabetes mellitus, hypercholesterolemia, and presence of CAD (p > 0.05 for all comparisons). Prevalence of hypertension and mean age were significantly higher in patients with MAC than in those without MAC (hypertension 74% vs 52%, p < 0.001; age 68 +/- 9 vs 58 +/- 10 years, p < 0.001, respectively). Age and hypertension were found to be independent positive risk factors for MAC, whereas T score and age-gender adjusted T score were found to be negatively and independently associated with MAC. In conclusion, we found that MAC in patients undergoing coronary angiography is independently and positively associated with age and hypertension and negatively associated with T-score, measurement of BMD. (c) 2007 Elsevier Inc. All rights reserved.