Background--The relationship between ideal cardiovascular health reflected in the cardiovascular health score (CVHS) and valvular heart disease is not known. The purpose of this study was to determine the association of CVHS attainment through midlife to late life with aortic stenosis prevalence and severity in late life. Methods and Results--The following 6 ideal cardiovascular health metrics were assessed in ARIC (Atherosclerosis Risk in Communities) Study participants at 5 examination visits between 1987 and 2013 (visits 1-4 in 1987-1998 and visit 5 in 2011- 2013): smoking, body mass index, total cholesterol, blood pressure, physical activity, and blood glucose. Percentage attained CVHS was calculated in 6034 participants as the sum of CVHS at each visit/the maximum possible score. Aortic stenosis was assessed by echocardiography at visit 5 on the basis of the peak aortic valve velocity. Aortic stenosis was categorized sclerosis, mild stenosis, and moderate-to-severe stenosis. Mean age was 76±5 years, 42% were men, and 22% were black. Mean percentage attained CVHS was 63±14%, and the prevalence of aortic stenosis stages were 15.9% for sclerosis, 4.3% for mild stenosis, and 0.7% for moderate-to-severe stenosis. Worse percentage attained CVHS was associated with higher prevalence of aortic sclerosis (P < 0.001 for trend), mild stenosis (P < 0.001), and moderate-to-severe stenosis (P=0.002), adjusting for age, sex, and race. Conclusions--Greater attainment of ideal cardiovascular health in midlife to late life is associated with a lower prevalence of aortic sclerosis and stenosis in late life in a large cohort of older adults.
Bibliographical noteFunding Information:
The ARIC (Atherosclerosis Risk in Communities) Study is performed as a collaborative study, supported by National Heart, Lung, and Blood Institute contracts (HHSN26820 1100005C, HHSN268201100006C, HHSN268201100007C, HHSN268201100008C, HHSN268201100009C, HHSN2682 01100010C, HHSN268201100011C, and HHSN268201100 012C). The work for this manuscript was also supported by National Heart, Lung, and Blood Institute grants K08HL116792 and R01HL135008 (Shah), American Heart
Association grant 14CRP20380422 (Shah), Watkins Discovery Award from the Brigham and Women’s Heart and Vascular Center (Shah), Novo Nordisk Research Foundation grant number NNF15OC0017456 (Sengeløv), and in part by R01-HL131532, R01-HL134168, and a grant from the Ellison Foundation (Cheng).
- Aortic stenosis
- Primary prevention
- Risk factor