Ethnic differences in aortic valve thickness and related clinical factors.
BACKGROUND
Prior studies suggest that the causes of calcific aortic valve (AV) disease involve chronic inflammation, lipoprotein levels, and calcium metabolism, all of which may differ among race-ethnic groups. We sought to determine whether AV thickness differs by race-ethnicity in a large multiethnic population-based cohort.


METHODS
The Northern Manhattan Study includes stroke-free community-based Hispanic (57%), non-Hispanic black (22%), and non-Hispanic white (21%) participants. The relation between AV thickness on transthoracic echocardiography and clinical risk factors for atherosclerosis was evaluated among 2,085 participants using polytomous logistic regression models. Aortic valve thickness was graded in 3 categories (normal, mild, and moderate/severe) based on leaflet thickening and calcification.


RESULTS
Mild AV thickness was present in 44.4% and moderate/severe thickness in 5.7% of the cohort, with the lowest frequency of moderate/severe thickness seen particularly among Hispanic women. In multivariate models adjusting for age, sex, race-ethnicity, body mass index, hypertension, coronary artery disease, blood glucose, and high-density lipoprotein cholesterol, Hispanics had significantly less moderate/severe AV thickness (odds ratio 0.43, 95% CI 0.25-0.73) than non-Hispanic whites. Men were almost 2-fold as likely to have moderate/severe AV thickness compared with women (odds ratio 1.96, 95% CI 1.24-3.10).


CONCLUSIONS
In this large multiethnic population-based cohort, there were ethnic differences in the degree of AV thickness. Hispanic ethnicity was strongly protective against AV thickness. This effect was not related to traditional risk factors, suggesting that unmeasured factors related to Hispanic ethnicity and AV thickness may be responsible.
Sashida
Yukiko
Y
Department of Medicine, Columbia University, New York, NY 10032, USA.
Rodriguez
Carlos J
CJ
Boden-Albala
Bernadette
B
Jin
Zhezhen
Z
Elkind
Mitchell S V
MS
Liu
Rui
R
Rundek
Tatjana
T
Sacco
Ralph L
RL
DiTullio
Marco R
MR
Homma
Shunichi
S
D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging*; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000208:ethnology*; D005260:Female; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging* / Q000208:ethnology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D014463:Ultrasonography