Cited by 247Cardiac Valve Diseases and TreatmentsAortic Disease and Treatment ApproachesCardiovascular Function and Risk Factors

Association Between Cardiovascular Risk Factors and Aortic Stenosis

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Yan, Andrew T., Koh, Maria, Chan, Kelvin K., Guo, Helen, Alter, David A., Austin, Peter C., Tu, Jack V., Wijeysundera, Harindra C. +1 more·2017·Journal of the American College of Cardiology

Abstract

Background Few longitudinal studies have delineated the association between traditional cardiovascular risk factors and development of aortic stenosis (AS).Objectives The authors examined the association between traditional cardiovascular risk factors and incident severe AS in a large, unselected elderly population.Methods This observational cohort study used multiple linked health care population-based databases of individuals older than 65 years on April 1, 2002, without prior valvular disease, coronary artery disease, heart failure, cardiac arrhythmia, cerebrovascular disease, congenital heart disease, or admissions with cardiac symptoms. The relationship between hypertension (HTN), diabetes, dyslipidemia, and incident severe AS requiring hospitalization or surgical or interventional treatment was examined.Results Among 1.12 million individuals followed for a median of 13 years, 20,995 subjects developed severe AS. Overall absolute incidence was 144 per 100,000 person-years (169 and 127 per 100,000 person-years in men and women, respectively). In cause-specific hazard models, HTN (adjusted hazard ratio [HR]: 1.71; 95% confidence interval [CI]: 1.66 to 1.76), diabetes (HR: 1.49; 95% CI: 1.44 to 1.54), and dyslipidemia (HR: 1.17; 95% CI: 1.14 to 1.21) were all significantly associated with increased risk of developing severe AS (all p < 0.001). There was a positive dose-response relationship between the number and duration of cardiac risk factors and risk of AS. In the Fine-Gray model, all 3 risk factors were independently associated with a higher incidence of AS. The population-attributable risk of AS associated with 3 cardiac risk factors was 34.4% (95% CI: 32.8 to 36.0).Conclusions HTN, diabetes, and dyslipidemia have independent and dose-response associations with incident AS in an unselected population of older individuals, and together accounted for approximately one-third of the incidence of severe AS.

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Authors
Yan, A. T., Koh, M., Chan, K. K., Guo, H., Alter, D. A., Austin, P. C., Tu, J. V., Wijeysundera, H. C., & Ko, D. T.
Affiliations
  • St. Michael's Hospital (CA)
  • Institute for Clinical Evaluative Sciences (CA)
  • Sunnybrook Health Science Centre (CA)
  • University Health Network (CA)
Corresponding author
Yan, Andrew T.
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
2017-03
Volume
69
Issue
12
Pages
1523-1532
ISSN
0735-1097 (ISSN-L)
OpenAlex
W2603952975
Cited by
247
References
43
Citations by year
2026: 17 · 2025: 33 · 2024: 33 · 2023: 26 · 2022: 37 · 2021: 26 · 2020: 21 · 2019: 22 · 2018: 20 · 2017: 12
FWCI
15.85
Type
journal article
Language
en
Open access
Locations
  • Journal of the American College of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Heart and Stroke Foundation of Canada
  • Institute for Clinical Evaluative Sciences
  • Ontario Ministry of Health and Long-Term Care
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Aortic Disease and Treatment Approaches
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
Keywords
aortic stenosis, cardiovascular risk factors, hypertension, diabetes mellitus, dyslipidemia, older adults, population attributable risk, dose-response relationship
MeSH terms
Aged, Aged, 80 and over, Aortic Valve Stenosis, Female, Humans, Male, Ontario, Risk Factors, Incidence

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