TRADITIONAL CARDIOVASCULAR RISK FACTORS AND THE RISK OF AORTIC VALVE DISEASE: A SYSTEMATIC REVIEW

Abstract

Background: Aortic valve disease (AVD) is often described in association with traditional cardiovascular risk factors (TCVRFs), given similarities in pathogenesis with vascular atherosclerosis. However, the link between AVD and TCVRFs has not previously been systematically assessed. Methods: We searched MEDLINE and EMBASE for articles describing AVD and TCVRFs. AVD was defined as aortic valve stenosis, sclerosis or disease progression. All study designs with a control group were included. A qualitative synthesis of studies reporting multivariable analysis was conducted. Study heterogeneity did not allow for meta-analysis. Results: Of 3,768 articles identifed, 28 met inclusion criteria (n=1,529,450 patients). Among the 21 studies reporting multivariable analysis, age was most frequently associated with AVD (87% of studies). Male gender, body fat, blood pressure, lipids and smoking were associated with AVD in 40-50% of studies, while most studies (70%) did not find an association with diabetes. Black race independently predicted risk of AVD in two studies investigating race. Conclusion: All TCVRFs were reported to be independently associated with the development of AVD. Some were reported more commonly than others, possibly refecting subtle differences in pathogenesis compared to vascular atherosclerosis. Our results suggest that improvement of modifable TCVRFs may prevent the development of AVD. I.