Cumulative incidence and predictors of acquired aortic stenosis in a large population of men followed for up to 43 years

Kontogeorgos, Silvana; Thunström, Erik; Lappas, Georgios; Rosengren, Annika; Fu, Michael

doi:10.1186/s12872-022-02487-y

Cited by 4 publications

(6 citation statements)

References 34 publications

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“…We found that even women in the high-normal BMI group (22.5 -<25 kg/m²) had a higher risk of being diagnosed with AS, which increased with higher BMI, reaching a risk of over three times higher in women with severe obesity. This association between AS and BMI, even in individuals with what is considered a normal BMI (22.5-<25 kg/m²), was also found in one of our previous studies in men 13 . We also noted that women with higher BMI are diagnosed with AS at a younger age, likely contributing, albeit to a comparatively minor extent, to increased morbidity and mortality in overweight or obese people.…”

Section: Discussionsupporting

confidence: 85%

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Association between Body Mass Index and Risk of Aortic Stenosis in Women

Kontogeorgos,

Rosengren,

Sandström

et al. 2023

Preprint

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BackgroundOverweight and obesity are increasing globally, as are life expectancy and disorders associated with aging, including calcific aortic stenosis (AS). Studies investigating the correlation between high body mass index (BMI) and AS are contradictory and inconclusive. This study examines a potential association between BMI and early AS in women.MethodsBy linking the Swedish Medical Birth Register (MBR) and the Swedish National Patient Register (NPR), we included women between 18 and 55 years with a first childbirth from 1982 to 2020. Diagnosis of subsequent AS and comorbidities were defined according to the International Classification of Diseases (ICD) 8, 9, and 10 codes. The women were divided into eight groups based on their BMI, with BMI 20 kg/m2-<22.5 kg/m2as reference. Cox proportional hazards regression models were used to investigate the difference in the risk of being diagnosed with AS.ResultsThe mean age at inclusion among 1,722,798 women was 28 years, and the mean BMI was 24 kg/m2. Some 21% were overweight (BMI 30 kg/m2-<35 kg/m2) and 10.7% were obese (BMI≥35 kg/m2). During a median follow-up of 19.5 years, 2,513 women (0.15%) were diagnosed with AS. The age-adjusted risk of being diagnosed with AS, compared to a reference group with BMI 20 -<22.5 kg/m2, increased with higher BMI to 2.8 (95%CI 2.43-3.24) times higher in women with BMI 30 -<35 kg/m2, and to 3.67 (95%CI 2.91-4.64) times higher in those with severe obesity (BMI ≥35 kg/m2). Similar results were found after excluding AS of rheumatic and congenital etiology.ConclusionsHigher BMI correlated with a higher risk of developing AS in women, regardless of etiology, beginning with increased risk even within the upper normal range, reaching a three times higher risk in women with severe obesity.Clinical perspectiveWhat is new?This study investigates a subpopulation seldom included in valvular heart diseases studies, younger women, showing that women with overweight and obesity have approximately three times higher risk to be diagnosed with AS.Even women in the BMI group considered high-normal (BMI 22.5 -<25 kg/m2) had higher risk for AS compared those with BMI 20 -<22.5 kg/m2.What are the clinical implications?The percentage of individuals with overweight and obesity increases and in the same time, AS becomes more prevalent as the population ages. Considering that there is no medical treatment that can ameliorate AS prognosis, prevention by maintaining a low-normal or normal BMI becomes even more important.

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Section: Discussionsupporting

confidence: 85%

“…A link between obesity and AS has been shown 11 . In addition, in previous work from our group, we found that middle-aged men with obesity were predisposed to be diagnosed with AS later in life 12,13 . However, although these studies had an extended follow-up, only men who were middle-aged at baseline were included.…”

Section: Introductionsupporting

confidence: 55%

Association between Body Mass Index and Risk of Aortic Stenosis in Women

Kontogeorgos,

Rosengren,

Sandström

et al. 2023

Preprint

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“…In a randomly selected group of male participants (N=9998) born from 1915 to 1925 in Gothenburg, Sweden, 7494 were examined and followed until a diagnosis of aortic stenosis or death (maximum follow-up time 42.8 years). 16 The lifetime cumulative incidence of aortic stenosis in the middle-aged male population was 3.2%.…”

Section: Valvular Diseasesmentioning

confidence: 99%

“…In the Swedish General Population Study, higher BMI, obesity, cholesterol, hypertension, AF, smoking, and heredity for stroke were associated with aortic stenosis. 16 The HRs of being diagnosed with aortic stenosis for males with a baseline BMI of 25 to 27.5, 27.5 to 30, and >30 kg/m 2 were 1.99 (95% CI, 1.12–3.55), 2.98 (95% CI, 1.65–5.40), and 3.55 (95% CI, 1.84–6.87), respectively, with a BMI of 20 to 22.5 kg/m 2 used as a reference.…”

Section: Valvular Diseasesmentioning

confidence: 99%

Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association

Tsao¹,

Aday²,

Almarzooq³

et al. 2023

Circulation

2,547

247

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BACKGROUND: The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS: The American Heart Association, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2023 Statistical Update is the product of a full year’s worth of effort in 2022 by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. The American Heart Association strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year’s edition includes additional COVID-19 (coronavirus disease 2019) publications, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS: Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS: The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

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“…In the Swedish General Population Study, higher BMI, obesity, cholesterol, hypertension, AF, smoking, and heredity for stroke were associated with aortic stenosis. 22 The HRs of being diagnosed with aortic stenosis for males with a baseline BMI of 25 to 27.5, 27.5 to 30, and >30 kg/m 2 were 1.99 (95% CI, 1.12–3.55), 2.98 (95% CI, 1.65–5.40), and 3.55 (95% CI, 1.84–6.87), respectively, with BMI of 20 to 22.5 kg/m 2 used as reference.…”

Section: Valvular Diseasesmentioning

confidence: 99%

2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association

Martin,

Aday,

Almarzooq

et al. 2024

Circulation

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BACKGROUND: The American Heart Association (AHA), in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, nutrition, sleep, and obesity) and health factors (cholesterol, blood pressure, glucose control, and metabolic syndrome) that contribute to cardiovascular health. The AHA Heart Disease and Stroke Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, brain health, complications of pregnancy, kidney disease, congenital heart disease, rhythm disorders, sudden cardiac arrest, subclinical atherosclerosis, coronary heart disease, cardiomyopathy, heart failure, valvular disease, venous thromboembolism, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS: The AHA, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States and globally to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2024 AHA Statistical Update is the product of a full year’s worth of effort in 2023 by dedicated volunteer clinicians and scientists, committed government professionals, and AHA staff members. The AHA strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year’s edition includes additional global data, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS: Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS: The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

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Cumulative incidence and predictors of acquired aortic stenosis in a large population of men followed for up to 43 years

Cited by 4 publications

References 34 publications

Association between Body Mass Index and Risk of Aortic Stenosis in Women

Association between Body Mass Index and Risk of Aortic Stenosis in Women

Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association

2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association

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