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. 2022 Aug:355:68-75.
doi: 10.1016/j.atherosclerosis.2022.06.003. Epub 2022 Jun 13.

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

Ellen Boakye  1 , Zeina Dardari  1 , Olufunmilayo H Obisesan  2 , Albert D Osei  2 , Frances M Wang  3 , Yasuyuki Honda  3 , Omar Dzaye  1 , Ngozi Osuji  1 , John Jeffery Carr  4 , Candace M Howard-Claudio  5 , Lynne Wagenknecht  6 , Suma Konety  7 , Josef Coresh  3 , Kunihiro Matsushita  3 , Michael J Blaha  8 , Seamus P Whelton  1
Affiliations

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

Ellen Boakye et al. Atherosclerosis. 2022 Aug.

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.

Keywords: Aortic valve calcification; Cardiovascular risk factors; Older adults; Prevalence; Race; Sex.

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Conflict of interest statement

Conflict of Interest

The authors have no conflict of interest to disclose

Figures

Figure 1:
Figure 1:
Aortic Valve Calcification Distribution by Race and Sex
Figure 2:
Figure 2:
Estimated Probability of Aortic Valve Calcification by Age stratified by Race and Sex 2(A): Estimated Probability of Aortic Valve Calcification > 0 AU by Age stratified by Race and Sex 2(B): Estimated Probability of Aortic Valve Calcification > 100 AU by Age stratified by Race and Sex
See this image and copyright information in PMC

Comment in

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