Sex-and race-specific burden of aortic valve calcification among older adults without overt coronary heart disease: The Atherosclerosis Risk in Communities Study.

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Citation: Atherosclerosis. 355:68-75, 2022 08.PMID: 35718559Institution: MedStar Union Memorial HospitalDepartment: Internal Medicine ResidencyForm of publication: Journal ArticleMedline article type(s): Journal Article | Research Support, N.I.H., ExtramuralSubject headings: *Aortic Valve Stenosis | *Atherosclerosis | *Coronary Artery Disease | Aged | Aged, 80 and over | Aortic Valve Stenosis/dg [Diagnostic Imaging] | Aortic Valve Stenosis/ep [Epidemiology] | Aortic Valve/dg [Diagnostic Imaging] | Aortic Valve/pa [Pathology] | Atherosclerosis/dg [Diagnostic Imaging] | Atherosclerosis/ep [Epidemiology] | Calcinosis | Coronary Artery Disease/ep [Epidemiology] | Female | Humans | Lipoprotein(a) | Male | Risk FactorsYear: 2022ISSN:
  • 0021-9150
Name of journal: AtherosclerosisAbstract: BACKGROUND AND AIMS: The prevalence of aortic valve calcification (AVC) increases with age. However, the sex-and race-specific burden of AVC and associated cardiovascular risk factors among adults >=75 years are not well studied.CONCLUSIONS: AVC, although highly prevalent, was not universally present in this cohort of older adults. White males had ~50-60% higher prevalence than other race-sex groups. Moreover, cardiovascular risk factors measured in older age showed significant association with AVC. Copyright © 2022 Elsevier B.V. All rights reserved.METHODS: We calculated the sex-and race-specific burden of AVC among 2283 older Black and White adults (mean age:80.5 [SD:4.3] years) without overt coronary heart disease from the Atherosclerosis Risk in Communities Study who underwent non-contrast cardiac-gated CT-imaging at visit 7 (2018-2019). Using Poisson regression with robust variance, we calculated the adjusted prevalence ratios (aPR) of the association of AVC with cardiovascular risk factors.RESULTS: The overall AVC prevalence was 44.8%, with White males having the highest prevalence at 58.2%. The prevalence was similar for Black males (40.5%), White females (38.9%), and Black females (36.8%). AVC prevalence increased significantly with age among all race-sex groups. The probability of any AVC at age 80 years was 55.4%, 40.0%, 37.3%, and 36.2% for White males, Black males, White females, and Black females, respectively. Among persons with prevalent AVC, White males had the highest median AVC score (100.9 Agatston Units [AU]), followed by Black males (68.5AU), White females (52.3AU), and Black females (46.5AU). After adjusting for cardiovascular risk factors, Black males (aPR:0.53; 95%CI:0.33-0.83), White females (aPR:0.68; 95%CI:0.61-0.77), and Black females (aPR:0.49; 95%CI:0.31-0.77) had lower AVC prevalence compared to White males. In addition, systolic blood pressure, non-HDL-cholesterol, and lipoprotein (a) were independently associated with AVC, with no significant race/sex interactions.All authors: Blaha MJ, Boakye E, Carr JJ, Coresh J, Dardari Z, Dzaye O, Honda Y, Howard-Claudio CM, Konety S, Matsushita K, Obisesan OH, Osei AD, Osuji N, Wagenknecht L, Wang FM, Whelton SPFiscal year: FY2023Digital Object Identifier: Date added to catalog: 2022-10-20
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Journal Article MedStar Authors Catalog Article 35718559 Available 35718559

BACKGROUND AND AIMS: The prevalence of aortic valve calcification (AVC) increases with age. However, the sex-and race-specific burden of AVC and associated cardiovascular risk factors among adults >=75 years are not well studied.

CONCLUSIONS: AVC, although highly prevalent, was not universally present in this cohort of older adults. White males had ~50-60% higher prevalence than other race-sex groups. Moreover, cardiovascular risk factors measured in older age showed significant association with AVC. Copyright © 2022 Elsevier B.V. All rights reserved.

METHODS: We calculated the sex-and race-specific burden of AVC among 2283 older Black and White adults (mean age:80.5 [SD:4.3] years) without overt coronary heart disease from the Atherosclerosis Risk in Communities Study who underwent non-contrast cardiac-gated CT-imaging at visit 7 (2018-2019). Using Poisson regression with robust variance, we calculated the adjusted prevalence ratios (aPR) of the association of AVC with cardiovascular risk factors.

RESULTS: The overall AVC prevalence was 44.8%, with White males having the highest prevalence at 58.2%. The prevalence was similar for Black males (40.5%), White females (38.9%), and Black females (36.8%). AVC prevalence increased significantly with age among all race-sex groups. The probability of any AVC at age 80 years was 55.4%, 40.0%, 37.3%, and 36.2% for White males, Black males, White females, and Black females, respectively. Among persons with prevalent AVC, White males had the highest median AVC score (100.9 Agatston Units [AU]), followed by Black males (68.5AU), White females (52.3AU), and Black females (46.5AU). After adjusting for cardiovascular risk factors, Black males (aPR:0.53; 95%CI:0.33-0.83), White females (aPR:0.68; 95%CI:0.61-0.77), and Black females (aPR:0.49; 95%CI:0.31-0.77) had lower AVC prevalence compared to White males. In addition, systolic blood pressure, non-HDL-cholesterol, and lipoprotein (a) were independently associated with AVC, with no significant race/sex interactions.

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