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; Zeina Dardari; Olufunmilayo H. Obisesan; Albert D. Osei; Frances M. Wang; Yasuyuki Honda; Omar Dzaye; Ngozi Osuji; John Jeffery Carr; Candace M. Howard-Claudio; Lynne Wagenknecht; Suma Konety; Josef Coresh; Kunihiro Matsushita; Michael J. Blaha; Seamus P. Whelton

doi:10.1016/j.atherosclerosis.2022.06.003

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, Zeina Dardari, Olufunmilayo H. Obisesan, Albert D. Osei, Frances M. Wang, Yasuyuki Honda, Omar Dzaye, Ngozi Osuji, John Jeffery Carr, Candace M. Howard-Claudio, Lynne Wagenknecht, Suma Konety, Josef Coresh, Kunihiro Matsushita, Michael J. Blaha, Seamus P. Whelton

Medicine - Cardiology Division

Research output: Contribution to journal › Article › peer-review

9 Scopus citations

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.

Original language	English (US)
Pages (from-to)	68-75
Number of pages	8
Journal	Atherosclerosis
Volume	355
DOIs	https://doi.org/10.1016/j.atherosclerosis.2022.06.003
State	Published - Aug 2022

Bibliographical note

Funding Information:
The ARIC study has been funded in whole or in part with federal funds from the National Heart, Lung, and Blood Institute ( NHLBI, National Institutes of Health h ( NIH, Department of Health and Human Services s, under contract numbers HHSN268201700001I , HHSN268201700002I , HHSN268201700003I , HHSN268201700005I , and HHSN268201700004I . The authors thank the ARIC study staff and participants for their important contributions. The present study is also supported by R01HL136592 (PIs-Drs. Matsushita and Blaha). In addition, Dr. Frances Wang received support from the NIH T32 institutional training grant (T32 HL007024).

Publisher Copyright:
© 2022 Elsevier B.V.

Keywords

Aortic valve calcification
Cardiovascular risk factors
Older adults
Prevalence
Race
Sex

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This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.atherosclerosis.2022.06.003

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Boakye, E., Dardari, Z., Obisesan, O. H., Osei, A. D., Wang, F. M., Honda, Y., Dzaye, O., Osuji, N., Carr, J. J., Howard-Claudio, C. M., Wagenknecht, L., Konety, S., Coresh, J., Matsushita, K., Blaha, M. J., & Whelton, S. P. (2022). Sex-and race-specific burden of aortic valve calcification among older adults without overt coronary heart disease: The Atherosclerosis Risk in Communities Study. Atherosclerosis, 355, 68-75. https://doi.org/10.1016/j.atherosclerosis.2022.06.003

Boakye, E, Dardari, Z, Obisesan, OH, Osei, AD, Wang, FM, Honda, Y, Dzaye, O, Osuji, N, Carr, JJ, Howard-Claudio, CM, Wagenknecht, L, Konety, S, Coresh, J, Matsushita, K, Blaha, MJ & Whelton, SP 2022, 'Sex-and race-specific burden of aortic valve calcification among older adults without overt coronary heart disease: The Atherosclerosis Risk in Communities Study', Atherosclerosis, vol. 355, pp. 68-75. https://doi.org/10.1016/j.atherosclerosis.2022.06.003

@article{ce9781dde69d4f348fcd582b853bdafc,

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

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",

author = "Ellen Boakye and Zeina Dardari and Obisesan, {Olufunmilayo H.} and Osei, {Albert D.} and Wang, {Frances M.} and Yasuyuki Honda and Omar Dzaye and Ngozi Osuji and Carr, {John Jeffery} and Howard-Claudio, {Candace M.} and Lynne Wagenknecht and Suma Konety and Josef Coresh and Kunihiro Matsushita and Blaha, {Michael J.} and Whelton, {Seamus P.}",

note = "Funding Information: The ARIC study has been funded in whole or in part with federal funds from the National Heart, Lung, and Blood Institute ( NHLBI, National Institutes of Health h ( NIH, Department of Health and Human Services s, under contract numbers HHSN268201700001I , HHSN268201700002I , HHSN268201700003I , HHSN268201700005I , and HHSN268201700004I . The authors thank the ARIC study staff and participants for their important contributions. The present study is also supported by R01HL136592 (PIs-Drs. Matsushita and Blaha). In addition, Dr. Frances Wang received support from the NIH T32 institutional training grant (T32 HL007024). Publisher Copyright: {\textcopyright} 2022 Elsevier B.V.",

year = "2022",

month = aug,

doi = "10.1016/j.atherosclerosis.2022.06.003",

language = "English (US)",

volume = "355",

pages = "68--75",

journal = "Atherosclerosis",

issn = "0021-9150",

publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Sex-and race-specific burden of aortic valve calcification among older adults without overt coronary heart disease

T2 - The Atherosclerosis Risk in Communities Study

AU - Boakye, Ellen

AU - Dardari, Zeina

AU - Obisesan, Olufunmilayo H.

AU - Osei, Albert D.

AU - Wang, Frances M.

AU - Honda, Yasuyuki

AU - Dzaye, Omar

AU - Osuji, Ngozi

AU - Carr, John Jeffery

AU - Howard-Claudio, Candace M.

AU - Wagenknecht, Lynne

AU - Konety, Suma

AU - Coresh, Josef

AU - Matsushita, Kunihiro

AU - Blaha, Michael J.

AU - Whelton, Seamus P.

N1 - Funding Information: The ARIC study has been funded in whole or in part with federal funds from the National Heart, Lung, and Blood Institute ( NHLBI, National Institutes of Health h ( NIH, Department of Health and Human Services s, under contract numbers HHSN268201700001I , HHSN268201700002I , HHSN268201700003I , HHSN268201700005I , and HHSN268201700004I . The authors thank the ARIC study staff and participants for their important contributions. The present study is also supported by R01HL136592 (PIs-Drs. Matsushita and Blaha). In addition, Dr. Frances Wang received support from the NIH T32 institutional training grant (T32 HL007024). Publisher Copyright: © 2022 Elsevier B.V.

PY - 2022/8

Y1 - 2022/8

N2 - 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.

AB - 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.

KW - Aortic valve calcification

KW - Cardiovascular risk factors

KW - Older adults

KW - Prevalence

KW - Race

KW - Sex

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SN - 0021-9150

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ER -

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

Abstract

Bibliographical note

Keywords

UN SDGs

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