Prevalence and Common Cardiovascular Risk Factors in Aortic Valve Calcification in the Middle-aged General Population.

Abstract

Aim: Aortic valve calcification (AVC) is an underlying pathophysiological mechanism for aortic stenosis which is common in the elderly, but less is known in younger individuals. The aim was to study the prevalence and associated characteristics of AVC in a middle-aged general population.

Methods: Data were obtained from the Swedish CArdioPulmonary bioImage Study (SCAPIS) comprising 30,154 individuals 50 to 64 years from the general population recruited in Sweden between 2013-2018. AVC was assessed visually on computed tomography (CT) and categorized as evident or not. Population attributable risk proportion (PARP) was calculated for six modifiable risk factors (smoking, hypertension, hyperlipidemia, diabetes, BMI ≥median and kidney dysfunction [eGFR <60 ml/min/1.73 m2]).

Results: In total, 29,221 individuals with CT images available were included (mean age 57.5 years, 51% female) and AVC was present in 2,053 (7%). The AVC prevalence increased with age (50-54 years: 3%; 55-59 years: 7%; 60-64 years: 11%). In analyses adjusted for age, sex, smoking and study site, male sex (OR 2.02, 95% CI 1.84-2.22), hyperlipidemia (1.88 [1.68-2.11]), hypertension (1.73 [1.57-1.91]), diabetes (1.66 [1.39-1.97]), kidney dysfunction (1.54 [1.10-2.11]), smoking (1.36 [1.24-1.50]), age (increment by one year) (1.12 [1.11-1.13]) and BMI (increment by one unit) (1.04 [1.03-1.05) were associated with AVC. The PARP of AVC associated with the six modifiable risk factors was 34.5% (95% CI 29.6-39.4).

Conclusions: In this large, contemporary middle-aged general population, AVC was prevalent in as many as 7% and six cardiovascular risk factors contributed to one third of the prevalence of AVC.