Racial Differences in the Prevalence of Severe Aortic Stenosis
Open accessAbstract
Background: In an era of expanded treatment options for severe aortic stenosis, it is important to understand risk factors for the condition. It has been suggested that severe aortic stenosis is less common in African Americans, but there are limited data from large studies. Methods and Results: The Synthetic Derivative at Vanderbilt University Medical Center, a database of over 2.1 million de‐identified patient records, was used to identify individuals who had undergone echocardiography. The association of race with severe aortic stenosis was examined using multivariable logistic regression analyses adjusting for conventional risk factors. Of the 272 429 eligible patients (mean age 45 years, 44% male) with echocardiography, 14% were African American and 82% were Caucasian. Severe aortic stenosis was identified in 106 (0.29%) African‐American patients and 2030 (0.91%) Caucasian patients (crude OR 0.32, 95% CI [0.26, 0.38]). This difference persisted in multivariable‐adjusted analyses ( OR 0.41 [0.33, 0.50], P <0.0001). African‐American individuals were also less likely to have severe aortic stenosis due to degenerative calcific disease (adjusted OR 0.47 [0.36, 0.61]) or congenitally bicuspid valve (crude OR 0.13 [0.02, 0.80], adjusted OR dependent on age). Referral bias against those with severe valvular disease was assessed by comparing the prevalence of severe mitral regurgitation in Caucasians and African Americans and no difference was found. Conclusions: These findings suggest that African Americans are at significantly lower risk of developing severe aortic stenosis than Caucasians.
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Severe AS is less prevalent among NH-Black individuals, and the frequency of bicuspid morphology is lower.
“Among the few studies published to date reporting on the race/ethnicity implications it has been shown that severe AS is less prevalent among NH-Black, as well as the frequency of bicuspid morphology23,24.”
From Characterization of Aortic Valve Stenosis by CT Angiography in a Diverse US Cohort (2025) · cites this paper as [23]
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“Race was classified using observer-reported determination, which has been shown to have >92% concordance with selfreported race and ancestry based on genetic biomarkers.(9,10) To address the possibility that Caucasians with severe valvular disease were more likely to be referred for echocardiogram compared with Africa…”
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Characterization of Aortic Valve Stenosis by CT Angiography in a Diverse US Cohort
Lorenzatti, D., Filtz, A., Pina, P., Geers, J., Gilman, J., Daich, J., Ippolito, P., Aftab, A., Schenone, A. L., Gongora, C. A., et al. (2025) · Circulation: Cardiovascular Imaging · doi:10.1161/circimaging.124.017858 · Cited by 7 · see citing works
- Authors
- Patel, D. K., Green, K. D., Fudim, M., Harrell, F. E., Wang, T. J., & Robbins, M. A.
- Affiliations
- Vanderbilt University Medical Center (US)
- Venue
- Journal of the American Heart Association
- Published
- 2014-05-22
- Volume
- 3
- Issue
- 3
- Pages
- e000879-e000879
- ISSN
- 2047-9980 (ISSN-L)
- PMC
- PMC4309086
- OpenAlex
- W2135854379
- Cited by
- 127
- References
- 4
- Citations by year
- 2026: 8 · 2025: 11 · 2024: 12 · 2023: 13 · 2022: 14 · 2021: 18 · 2020: 17 · 2019: 11 · 2018: 8 · 2017: 4 · 2016: 5 · 2015: 6
- FWCI
- 3.44
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- Journal of the American Heart Association (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- Vanderbilt University (ULTR000445)
- Vanderbilt University Medical Center (ULTR000445)
- Georgia Clinical and Translational Science Alliance (ULTR000445)
- National Institutes of Health (ULTR000445)
- U.S. Public Health Service (ULTR000445)
- National Heart, Lung, and Blood Institute (T32HL007411)
- National Center for Advancing Translational Sciences (UL‐TR‐000445)
- Core Research for Evolutional Science and Technology
- 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 › Public Health, Environmental and Occupational Health › Streptococcal Infections and Treatments
- Keywords
- severe aortic stenosis, racial differences, African Americans, prevalence, bicuspid aortic valve, congenital heart disease, referral bias, mitral regurgitation, echocardiography, risk factors
- MeSH terms
- Adult, Age Factors, Aged, Aged, 80 and over, Aortic Valve Stenosis, Black or African American, Echocardiography, Female, Humans, Male, Middle Aged, Risk Factors, Tennessee, Prevalence, Logistic Models, White People, Young Adult
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