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

TitleSex-and race-specific burden of aortic valve calcification among older adults without overt coronary heart disease: The Atherosclerosis Risk in Communities Study.
Publication TypeJournal Article
Year of Publication2022
AuthorsBoakye E, Dardari Z, Obisesan OH, Osei AD, Wang FM, Honda Y, Dzaye O, Osuji N, Carr JJeffery, Howard-Claudio CM, Wagenknecht L, Konety S, Coresh J, Matsushita K, Blaha MJ, Whelton SP
JournalAtherosclerosis
Volume355
Pagination68-75
Date Published2022 Aug
ISSN1879-1484
KeywordsAged, Aged, 80 and over, Aortic Valve, Aortic Valve Stenosis, Atherosclerosis, Calcinosis, Coronary Artery Disease, Female, Humans, Lipoprotein(a), Male, Risk Factors
Abstract

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.

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.

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.

DOI10.1016/j.atherosclerosis.2022.06.003
Alternate JournalAtherosclerosis
PubMed ID35718559