Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Region Västra Götaland, Sahlgrenska University Hospital/Östra Hospital, Diagnosvägen 11, 416 50, Gothenburg, Sweden.
BMC Cardiovasc Disord. 2022 Feb 13;22(1):43. doi: 10.1186/s12872-022-02487-y.
Acquired aortic stenosis (AS) increases with age and has high mortality without intervention. Factors predicting its development are unclear, although atherosclerotic factors are assumed to be involved. Our aim in this study is to estimate the lifetime cumulative incidence and predictors of AS in middle-aged men.
We included a random sample of men (n = 9998) born 1915-1925 in Gothenburg, Sweden. From them, 7,494 were examined and followed until a diagnosis of AS or death (maximum follow-up time 42.8 years). We identified AS diagnosis from the Swedish National Patient Registry and deaths from the Swedish Cause of Death Registry by using International Classification of Disease (ICD) diagnostic criteria. To study time-dependent relationships between AS and risk factors with death as the competing risk, we divided the cohort into three overlapping follow-up groups: 25-43, 30-43 and 35-43 years. We used age-adjusted Cox proportional hazards model to identify predictors of AS.
The lifelong cumulative incidence of AS was 3.2%. At baseline, participants in the third group had a healthier lifestyle, lower body mass index (BMI), blood pressure, and serum cholesterol levels. Higher BMI, obesity, cholesterol, hypertension, atrial fibrillation, smoking and heredity for stroke were associated with AS. With BMI of 20-22.5 as a reference, hazard ratios of being diagnosed with AS for men with a baseline BMI of 25-27.5 kg/m, 27.5-30 kg/m and > 30 kg/m 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.
The lifetime cumulative incidence of AS in middle-aged male population was 3.2%. Multiple atherosclerotic risk factors, particularly high BMI might be associated with a higher risk of developing AS.
后天性主动脉瓣狭窄（AS）随年龄增长而增加，如果不进行干预，死亡率很高。尽管推测其发展与动脉粥样硬化因素有关，但目前尚不清楚哪些因素可以预测其发生。本研究旨在评估中年男性 AS 的终生累积发病率及其预测因素。
我们纳入了瑞典哥德堡 1915-1925 年出生的男性的随机样本（n=9998）。其中 7494 人接受了检查，并随访至 AS 诊断或死亡（最长随访时间 42.8 年）。我们通过使用国际疾病分类（ICD）诊断标准，从瑞典国家患者登记处和瑞典死因登记处确定 AS 诊断和死亡原因。为了研究 AS 与以死亡为竞争风险的危险因素之间的时间依赖性关系，我们将队列分为三个重叠的随访组：25-43 岁、30-43 岁和 35-43 岁。我们使用年龄调整的 Cox 比例风险模型来确定 AS 的预测因素。
AS 的终生累积发病率为 3.2%。在基线时，第 3 组的参与者生活方式更健康，体重指数（BMI）、血压和血清胆固醇水平更低。较高的 BMI、肥胖、胆固醇、高血压、心房颤动、吸烟和中风家族史与 AS 相关。以 BMI 为 20-22.5 为参考，基线 BMI 为 25-27.5kg/m、27.5-30kg/m 和>30kg/m 的男性被诊断为 AS 的风险比分别为 1.99（95%CI 1.12-3.55）、2.98（95%CI 1.65-5.40）和 3.55（95%CI 1.84-6.87）。
中年男性人群 AS 的终生累积发病率为 3.2%。多种动脉粥样硬化危险因素，尤其是较高的 BMI，可能与发生 AS 的风险增加相关。
