University Hospital Vall d'Hebron, Barcelona, Spain.
Eur J Prev Cardiol. 2013 Dec;20(6):1022-30. doi: 10.1177/2047487312451238. Epub 2012 Jun 7.
To determine the prevalence of aortic valve sclerosis (ASC) and stenosis (AS) in the elderly in a Mediterranean area and to identify associated clinical factors.
Population cross-sectional study in a random sample of 1068 people ≥65 years in a Mediterranean area. ASC was categorized as absent, mild-to-moderate, or moderate-to-severe depending on the severity of thickening and calcification. The relation between the severity of ASC and potential risk factors was assessed by multinomial logistic regression analysis. Some degree of thickening and/or calcification was present in 45.4%, of the sample, 73.5% in >85 years. AS prevalence was 3% for the total cohort and 7.4% in >85 years. Adjusting for gender it was found that age, smoking habit, hypertension, waist circumference, and ankle-brachial index <0.9 were associated with degrees of ASC. Except for waist circumference, there was a gradient between the magnitude of association and the severity of ASC. The OR for age was 1.56 (95% CI 1.39-1.76) for mild-to-moderate ASC and 2.03 (95% CI 1.72-2.4) for moderate-to-severe ASC, and for smoking habit 1.59 (95% CI 1.08-2.34) for mild-to-moderate ASC and 2.13 (95% CI 1.19-3.78) for moderate-to-severe ASC. Diabetes and renal impairment were associated with advanced but not with early stages of ASC.
The prevalence of ASC and AS in people ≥65 years is similar to that reported in other regions. The gradient in the association of cardiovascular risk factors with the severity of ASC suggests that they may be causally implied in the pathogenesis of the disease.
确定地中海地区老年人主动脉瓣硬化（ASC）和狭窄（AS）的患病率，并确定相关的临床因素。
在一个地中海地区的随机抽样中，对 1068 名≥65 岁的人群进行了横断面研究。根据增厚和钙化的严重程度，ASC 分为无、轻度至中度和中度至重度。采用多项逻辑回归分析评估 ASC 严重程度与潜在危险因素之间的关系。样本中 45.4%存在某种程度的增厚和/或钙化，85 岁以上者为 73.5%。总的队列中 AS 的患病率为 3%，85 岁以上者为 7.4%。调整性别后发现，年龄、吸烟习惯、高血压、腰围和踝臂指数<0.9 与 ASC 程度有关。除腰围外，ASC 严重程度与关联程度之间存在梯度。年龄的 OR 为轻度至中度 ASC 时为 1.56（95%CI 1.39-1.76），中度至重度 ASC 时为 2.03（95%CI 1.72-2.4），吸烟习惯的 OR 为轻度至中度 ASC 时为 1.59（95%CI 1.08-2.34），中度至重度 ASC 时为 2.13（95%CI 1.19-3.78）。糖尿病和肾功能不全与晚期 ASC 相关，但与早期 ASC 无关。
≥65 岁人群中 ASC 和 AS 的患病率与其他地区报告的相似。心血管危险因素与 ASC 严重程度之间的关联梯度表明，它们可能与疾病的发病机制有关。
