P2615Prevalence and lifetime risk factors for aortic stenosis in a general population of middle aged men in Sweden with 21 years follow up

Abstract

Background: Aortic stenosis (AS) is manly diagnosed in the elderly and keeps increasing with age. Consequently, an increasing number of patients with symptomatic aortic stenosis undergo aortic valve procedures. However, little is known about risk factors that contribute to the development and progression of aortic stenosis in the general population. Purpose: The aim of this study is to examine the prevalence of aortic stenosis at 71 years of age and what factors are associated with an increased risk of having aortic stenosis during a 21-year follow-up period. Methods: The subjects are a randomly selected cohort of urban Swedish men born in 1943. Baseline data on clinical characteristics as well as laboratory values were taken in 1993 when participants were 50 years old. The echocardiography was performed during a follow-up visit in 2014. Results: Echocardiography was performed in 535 men and aortic stenosis was found in 28 of these men (5.2%). Of the men with AS, 25.5% had BMI >30 kg/m2 compared to 9.3% in men without AS. There was no significant difference among men with and without AS with regard to smoking habits, physical activity, hypertension, baseline levels of NT-proBNP or hsTNT. In the multivariable regression model men with BMI (kg/m2) highest tertil (8.4%) in 1993 had an odds ratio (OR) of 1.21 (95% CI 1.08-1.35; p=0.0011), men with hyperlipidemia (total kolesterol >6.2 mmol/l or medical history of hyperlipidemia or medical treatment for hyperlipidemia) in 1993 (9.2%) had an OR of 3.03 (95% CI 1.35-6.77; p=0.0070) and men with fasting plasma glucose (mmol/l) at highest tertil (7.4%) in 1993 had an OR of 1.35 (95% CI 1.08-1.70; 0.0095) for developing AS in 2014. Finally, patients with both BMI>30 and hyperlipidemia in 1993 (9.2%) had an OR of 6.64 (95% CI 2.43-18.19; 0.0002) for evolving AS 21 years later. Conclusion: The prevalence of aortic stenosis in this random sample of Swedish men from the general population was 5.2% at the age of 71 years. Obesity and hyperlipidemia at 50 years of age were not only associated with higher risk for occurrence of aortic stenosis during life time per se but also had an additive effect on risk enhancement for the development of aortic stenosis. (Table Presented).