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Association Between Cardiovascular Risk Factors and Aortic Stenosis
Open accessAbstract
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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“Observational cohort studies have reported associations between dyslipidemia and increased risk of AS or aortic valve calcification.3,4”
From Rare Genetic Variants in LDLR , APOB , and PCSK9 Are Associated With Aortic Stenosis (2024) · cites this paper as [4]
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Guidelines on the management of valvular heart disease (version 2012)
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Metadata
- 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.
- ORCID
- 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
- bronze
- doi.org
- Licence
- 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 › Cardiology and Cardiovascular 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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