title: The prevalence of aortic stenosis in the elderly in Iceland and predictions for the coming decades: the AGES-Reykjavík study.
abstract: OBJECTIVE
  To evaluate the prevalence of significant aortic valve stenosis (AS) in a randomly selected study population of elderly individuals representing the general population of Iceland. Furthermore, to predict the number of individuals likely to have severe AS in the future.
  
  
  RESULTS
  Echocardiography and computed tomography (CT) data from individuals who participated in the AGES-Reykjavik study were used. Echocardiography data from 685 individuals (58% females) aged 67-95 years were available. In both sexes combined, the prevalence for severe AS, defined as an aortic valve area index of <0.6 cm2/m2, in the age groups<70, 70-79 and ≥80 years was 0.92%, 2.4% and 7.3%, respectively. A ROC analysis on the relation between the echocardiography data and the aortic valve calcium score on CT defined a score≥500 to be indicative of severe AS. Subsequently, in a CT study cohort of 5256 individuals the prevalence of severe AS in the same age groups was 0.80%, 4.0% and 9.5%, respectively. Overall, the prevalence of severe AS by echocardiography and CT in individuals≥70 years was 4.3% and 5.9%, respectively. A prediction on the number of elderly≥70 years for the coming decades demonstrated that patients with severe AS will have increased 2.4 fold by the year 2040 and will more than triple by the year 2060.
  
  
  CONCLUSIONS
  This study, in a cohort of elderly individuals representative of the general population in a Nordic country, predicts that AS will be a large health problem in the coming decades.
authors.affiliation: The Department of Cardiology, Landspitali, University Hospital, Reykjavík, Iceland. Electronic address: ragnarda@landspitali.is.
authors.forename: Ragnar
authors.initials: R
authors.lastname: Danielsen
authors.affiliation: The Icelandic Heart Association Research Institute, Kópavogur, Iceland; The University of Iceland, Reykjavík, Iceland.
authors.forename: Thor
authors.initials: T
authors.lastname: Aspelund
authors.affiliation: Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD, USA.
authors.forename: Tamara B
authors.initials: TB
authors.lastname: Harris
authors.affiliation: The Icelandic Heart Association Research Institute, Kópavogur, Iceland; The University of Iceland, Reykjavík, Iceland.
authors.forename: Vilmundur
authors.initials: V
authors.lastname: Gudnason
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000235:genetics / Q000473:pathology*; D001024:Aortic Valve Stenosis / Q000175:diagnosis* / Q000453:epidemiology* / Q000235:genetics; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies
keywords: Aortic valve stenosis; Elderly; Epidemiology; Future prediction; Prevalence