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

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


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 languageEnglish (US)
Pages (from-to)68-75
Number of pages8
StatePublished - 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.


  • Aortic valve calcification
  • Cardiovascular risk factors
  • Older adults
  • Prevalence
  • Race
  • Sex

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural


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