Ideal cardiovascular health and the prevalence and severity of aortic stenosis in elderly patients

Morten Sengeløv, Susan Cheng, Tor Biering-Sørensen, Kunihiro Matsushita, Suma Konety, Scott D. Solomon, Aaron R. Folsom, Amil M. Shah

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Article numbere007234
JournalJournal of the American Heart Association
Volume7
Issue number3
DOIs
StatePublished - Feb 1 2018

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Aortic Valve Stenosis
Health
Pathologic Constriction
Sclerosis
Heart Valve Diseases
Aortic Valve
Echocardiography
Blood Glucose
Atherosclerosis
Body Mass Index
Smoking
Cholesterol
Exercise
Blood Pressure

Keywords

  • Aortic stenosis
  • Echocardiography
  • Epidemiology
  • Primary prevention
  • Risk factor

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Ideal cardiovascular health and the prevalence and severity of aortic stenosis in elderly patients. / Sengeløv, Morten; Cheng, Susan; Biering-Sørensen, Tor; Matsushita, Kunihiro; Konety, Suma; Solomon, Scott D.; Folsom, Aaron R.; Shah, Amil M.

In: Journal of the American Heart Association, Vol. 7, No. 3, e007234, 01.02.2018.

Research output: Contribution to journalArticle

Sengeløv, Morten ; Cheng, Susan ; Biering-Sørensen, Tor ; Matsushita, Kunihiro ; Konety, Suma ; Solomon, Scott D. ; Folsom, Aaron R. ; Shah, Amil M. / Ideal cardiovascular health and the prevalence and severity of aortic stenosis in elderly patients. In: Journal of the American Heart Association. 2018 ; Vol. 7, No. 3.
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AU - Cheng, Susan

AU - Biering-Sørensen, Tor

AU - Matsushita, Kunihiro

AU - Konety, Suma

AU - Solomon, Scott D.

AU - Folsom, Aaron R.

AU - Shah, Amil M.

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N2 - 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.

AB - 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.

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KW - Echocardiography

KW - Epidemiology

KW - Primary prevention

KW - Risk factor

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