title: Ethnic differences in aortic valve thickness and related clinical factors.
abstract: 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.
authors.affiliation: Department of Medicine, Columbia University, New York, NY 10032, USA.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Sashida
authors.forename: Carlos J
authors.initials: CJ
authors.lastname: Rodriguez
authors.forename: Bernadette
authors.initials: B
authors.lastname: Boden-Albala
authors.forename: Zhezhen
authors.initials: Z
authors.lastname: Jin
authors.forename: Mitchell S V
authors.initials: MS
authors.lastname: Elkind
authors.forename: Rui
authors.initials: R
authors.lastname: Liu
authors.forename: Tatjana
authors.initials: T
authors.lastname: Rundek
authors.forename: Ralph L
authors.initials: RL
authors.lastname: Sacco
authors.forename: Marco R
authors.initials: MR
authors.lastname: DiTullio
authors.forename: Shunichi
authors.initials: S
authors.lastname: Homma
mesh_terms: 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