Highlights
- •The prevalence of aortic valve calcification in a cohort of older adults was 44.8%.
- •A significant proportion of older adults did not have any aortic valve calcification.
- •White males had the highest prevalence, nearly 50–60% higher than other race-sex groups.
- •Cardiovascular risk factors were associated with aortic valve calcification with no race/sex interactions.
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.
Graphical abstract
Graphical Abstract
Keywords
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Article Info
Publication History
Published online: June 13, 2022
Accepted:
June 3,
2022
Received in revised form:
May 20,
2022
Received:
March 30,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier B.V. All rights reserved.
