title: Association between degenerative aortic valve disease and long-term exposure to cardiovascular risk factors: results of the longitudinal population-based KORA/MONICA survey.
abstract: OBJECTIVE
  Degenerative aortic valve disease (DAVD), a common finding in the elderly, is associated with an increased risk of death due to cardiovascular causes. Taking advantage of its longitudinal design, this study evaluates the prevalence of DAVD and its temporal associations with long-term exposure to cardiovascular risk factors in the general population.
  
  
  RESULTS
  We studied 953 subjects (aged 25-74 years) from a random sample of German residents. Risk factors had been determined at a baseline investigation in 1994/95. At a follow-up investigation, 10 years later, standardized echocardiography determined aortic valve morphology and aortic valve area (AVA) as well as left ventricular geometry and function. At the follow-up study, the overall prevalence of DAVD was 28%. In logistic regression models adjusting for traditional cardiovascular risk factors at baseline age (OR 2.0 [1.7-2.3] per 10 years, P < 0.001), active smoking (OR 1.7 [1.1-2.4], P = 0.009) and elevated total cholesterol levels (OR 1.2 [1.1-1.3] per increase of 20 mg/dL, P < 0.001) were significantly related to DAVD at follow-up. Furthermore, age, baseline status of smoking, and total cholesterol level were significant predictors of a smaller AVA at follow-up study. In contrast, hypertension and obesity had no detectable relationship with long-term changes of aortic valve structure.
  
  
  CONCLUSIONS
  In the general population we observed a high prevalence of DAVD that is associated with long-term exposure to elevated cholesterol levels and active smoking. These findings strengthen the notion that smoking cessation and cholesterol lowering are promising treatment targets for prevention of DAVD.
authors.affiliation: Department of Internal Medicine II, University of Lübeck, Lübeck, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Stritzke
authors.forename: Patrick
authors.initials: P
authors.lastname: Linsel-Nitschke
authors.forename: Marcello Ricardo Paulista
authors.initials: MR
authors.lastname: Markus
authors.forename: Björn
authors.initials: B
authors.lastname: Mayer
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Lieb
authors.forename: Andreas
authors.initials: A
authors.lastname: Luchner
authors.forename: Angela
authors.initials: A
authors.lastname: Döring
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Koenig
authors.forename: Ulrich
authors.initials: U
authors.lastname: Keil
authors.forename: Hans-Werner
authors.initials: HW
authors.lastname: Hense
authors.forename: Heribert
authors.initials: H
authors.lastname: Schunkert
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D001021:Aortic Valve; D004452:Echocardiography; D005260:Female; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging / Q000401:mortality*; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications / Q000401:mortality; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000473:pathology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000401:mortality