Aortic sclerosis epidemiology and demographics: Difference between revisions

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==Overview==
==Overview==
Aortic sclerosis is non-obstructive degeneration of the aortic valve that presents later in life usually in patients over 65 years of age. Because aortic sclerosis is associated with coronary risk factors, it is also associated with a significant increase in the risk of cardiovascular death, [[myocardial infarction]] even in the absence of hemodynamically significant [[LVOT|left ventricular outflow tract obstruction]].<ref name="pmid8459080">{{cite journal |author=Lindroos M, Kupari M, Heikkilä J, Tilvis R |title=Prevalence of aortic valve abnormalities in the elderly: an echocardiographic study of a random population sample |journal=[[Journal of the American College of Cardiology]] |volume=21 |issue=5 |pages=1220–5 |year=1993 |month=April |pmid=8459080 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/0735-1097(93)90249-Z |accessdate=2012-04-10}}</ref><ref name="pmid9060903">{{cite journal |author=Stewart BF, Siscovick D, Lind BK, Gardin JM, Gottdiener JS, Smith VE, Kitzman DW, Otto CM |title=Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study |journal=[[Journal of the American College of Cardiology]] |volume=29 |issue=3 |pages=630–4 |year=1997 |month=March |pmid=9060903 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0735109796005633 |accessdate=2012-04-10}}</ref><ref name="pmid10403851">{{cite journal |author=Otto CM, Lind BK, Kitzman DW, Gersh BJ, Siscovick DS |title=Association of aortic-valve sclerosis with cardiovascular mortality and morbidity in the elderly |journal=[[The New England Journal of Medicine]] |volume=341 |issue=3 |pages=142–7 |year=1999 |month=July |pmid=10403851 |doi=10.1056/NEJM199907153410302 |url=http://dx.doi.org/10.1056/NEJM199907153410302 |accessdate=2012-04-10}}</ref>
Aortic sclerosis is non-obstructive degeneration of the aortic valve that presents predominantly in patients over 65 years of age who have risk factors for [[coronary artery disease]]. Because aortic sclerosis is associated with coronary artery disease risk factors, it is also associated with a significant increase in the risk of cardiovascular death, [[myocardial infarction]] even in the absence of hemodynamically significant [[LVOT|left ventricular outflow tract obstruction]].<ref name="pmid8459080">{{cite journal |author=Lindroos M, Kupari M, Heikkilä J, Tilvis R |title=Prevalence of aortic valve abnormalities in the elderly: an echocardiographic study of a random population sample |journal=[[Journal of the American College of Cardiology]] |volume=21 |issue=5 |pages=1220–5 |year=1993 |month=April |pmid=8459080 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/0735-1097(93)90249-Z |accessdate=2012-04-10}}</ref><ref name="pmid9060903">{{cite journal |author=Stewart BF, Siscovick D, Lind BK, Gardin JM, Gottdiener JS, Smith VE, Kitzman DW, Otto CM |title=Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study |journal=[[Journal of the American College of Cardiology]] |volume=29 |issue=3 |pages=630–4 |year=1997 |month=March |pmid=9060903 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0735109796005633 |accessdate=2012-04-10}}</ref><ref name="pmid10403851">{{cite journal |author=Otto CM, Lind BK, Kitzman DW, Gersh BJ, Siscovick DS |title=Association of aortic-valve sclerosis with cardiovascular mortality and morbidity in the elderly |journal=[[The New England Journal of Medicine]] |volume=341 |issue=3 |pages=142–7 |year=1999 |month=July |pmid=10403851 |doi=10.1056/NEJM199907153410302 |url=http://dx.doi.org/10.1056/NEJM199907153410302 |accessdate=2012-04-10}}</ref>


==Demographics==
==Demographics==
===Age===
===Age===
Aortic sclerosis commonly affects the elderly population aged above 65 years.<ref name="pmid15967862">{{cite journal |author=Freeman RV, Otto CM |title=Spectrum of calcific aortic valve disease: pathogenesis, disease progression, and treatment strategies |journal=[[Circulation]] |volume=111 |issue=24 |pages=3316–26 |year=2005 |month=June |pmid=15967862 |doi=10.1161/CIRCULATIONAHA.104.486738 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=15967862 |accessdate=2012-04-10}}</ref><ref name="pmid10403851">{{cite journal |author=Otto CM, Lind BK, Kitzman DW, Gersh BJ, Siscovick DS |title=Association of aortic-valve sclerosis with cardiovascular mortality and morbidity in the elderly |journal=[[The New England Journal of Medicine]] |volume=341 |issue=3 |pages=142–7 |year=1999 |month=July |pmid=10403851 |doi=10.1056/NEJM199907153410302 |url=http://dx.doi.org/10.1056/NEJM199907153410302 |accessdate=2012-04-10}}</ref><ref name="pmid9060903">{{cite journal |author=Stewart BF, Siscovick D, Lind BK, Gardin JM, Gottdiener JS, Smith VE, Kitzman DW, Otto CM |title=Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study |journal=[[Journal of the American College of Cardiology]] |volume=29 |issue=3 |pages=630–4 |year=1997 |month=March |pmid=9060903 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0735109796005633 |accessdate=2012-04-10}}</ref><ref name="pmid8459080">{{cite journal |author=Lindroos M, Kupari M, Heikkilä J, Tilvis R |title=Prevalence of aortic valve abnormalities in the elderly: an echocardiographic study of a random population sample |journal=[[Journal of the American College of Cardiology]] |volume=21 |issue=5 |pages=1220–5 |year=1993 |month=April |pmid=8459080 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/0735-1097(93)90249-Z |accessdate=2012-04-10}}</ref>
Aortic sclerosis commonly affects those aged 65 years and over.<ref name="pmid15967862">{{cite journal |author=Freeman RV, Otto CM |title=Spectrum of calcific aortic valve disease: pathogenesis, disease progression, and treatment strategies |journal=[[Circulation]] |volume=111 |issue=24 |pages=3316–26 |year=2005 |month=June |pmid=15967862 |doi=10.1161/CIRCULATIONAHA.104.486738 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=15967862 |accessdate=2012-04-10}}</ref><ref name="pmid10403851">{{cite journal |author=Otto CM, Lind BK, Kitzman DW, Gersh BJ, Siscovick DS |title=Association of aortic-valve sclerosis with cardiovascular mortality and morbidity in the elderly |journal=[[The New England Journal of Medicine]] |volume=341 |issue=3 |pages=142–7 |year=1999 |month=July |pmid=10403851 |doi=10.1056/NEJM199907153410302 |url=http://dx.doi.org/10.1056/NEJM199907153410302 |accessdate=2012-04-10}}</ref><ref name="pmid9060903">{{cite journal |author=Stewart BF, Siscovick D, Lind BK, Gardin JM, Gottdiener JS, Smith VE, Kitzman DW, Otto CM |title=Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study |journal=[[Journal of the American College of Cardiology]] |volume=29 |issue=3 |pages=630–4 |year=1997 |month=March |pmid=9060903 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0735109796005633 |accessdate=2012-04-10}}</ref><ref name="pmid8459080">{{cite journal |author=Lindroos M, Kupari M, Heikkilä J, Tilvis R |title=Prevalence of aortic valve abnormalities in the elderly: an echocardiographic study of a random population sample |journal=[[Journal of the American College of Cardiology]] |volume=21 |issue=5 |pages=1220–5 |year=1993 |month=April |pmid=8459080 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/0735-1097(93)90249-Z |accessdate=2012-04-10}}</ref>


Based on a large cohort study,<ref name="pmid9060903">{{cite journal |author=Stewart BF, Siscovick D, Lind BK, Gardin JM, Gottdiener JS, Smith VE, Kitzman DW, Otto CM |title=Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study |journal=[[Journal of the American College of Cardiology]] |volume=29 |issue=3 |pages=630–4 |year=1997 |month=March |pmid=9060903 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0735109796005633 |accessdate=2012-04-10}}</ref> that enrolled 5201 subjects aged 65 years or above demonstrated among patients aged 75 years and above, [[aortic sclerosis]] was present in ~37% patients while [[aortic stenosis]] was seen only in 2.6% patients.<ref name="pmid10073870">{{cite journal |author=Aronow WS, Ahn C, Shirani J, Kronzon I |title=Comparison of frequency of new coronary events in older subjects with and without valvular aortic sclerosis |journal=[[The American Journal of Cardiology]] |volume=83 |issue=4 |pages=599–600, A8 |year=1999 |month=February |pmid=10073870 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9149(98)00922-9 |accessdate=2012-04-10}}</ref>
In a large cohort study of 5,201 patients,<ref name="pmid9060903">{{cite journal |author=Stewart BF, Siscovick D, Lind BK, Gardin JM, Gottdiener JS, Smith VE, Kitzman DW, Otto CM |title=Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study |journal=[[Journal of the American College of Cardiology]] |volume=29 |issue=3 |pages=630–4 |year=1997 |month=March |pmid=9060903 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0735109796005633 |accessdate=2012-04-10}}</ref> [[aortic sclerosis]] was present in ~37% patients > 75 years of age while [[aortic stenosis]] was seen only in 2.6% of patients > 75 years of age.<ref name="pmid10073870">{{cite journal |author=Aronow WS, Ahn C, Shirani J, Kronzon I |title=Comparison of frequency of new coronary events in older subjects with and without valvular aortic sclerosis |journal=[[The American Journal of Cardiology]] |volume=83 |issue=4 |pages=599–600, A8 |year=1999 |month=February |pmid=10073870 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9149(98)00922-9 |accessdate=2012-04-10}}</ref>
Aortic sclerosis was even more common in another study of 425 patients with a mean age of 68 +/- 15 years who presented to an emergency room with [[chest pain]]. The rate of [[aortic sclerosis]] in this study was 49%.<ref name="pmid14736432">{{cite journal |author=Chandra HR, Goldstein JA, Choudhary N, O'Neill CS, George PB, Gangasani SR, Cronin L, Marcovitz PA, Hauser AM, O'Neill WW |title=Adverse outcome in aortic sclerosis is associated with coronary artery disease and inflammation |journal=[[Journal of the American College of Cardiology]] |volume=43 |issue=2 |pages=169–75 |year=2004 |month=January |pmid=14736432 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0735109703014104 |accessdate=2012-04-10}}</ref>  


Based on another study that evaluated 425 patients with a mean age of 68 +/- 15 years, presenting to the emergency room with [[chest pain]], an higher rate of [[aortic sclerosis]] was identified (~49%).<ref name="pmid14736432">{{cite journal |author=Chandra HR, Goldstein JA, Choudhary N, O'Neill CS, George PB, Gangasani SR, Cronin L, Marcovitz PA, Hauser AM, O'Neill WW |title=Adverse outcome in aortic sclerosis is associated with coronary artery disease and inflammation |journal=[[Journal of the American College of Cardiology]] |volume=43 |issue=2 |pages=169–75 |year=2004 |month=January |pmid=14736432 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0735109703014104 |accessdate=2012-04-10}}</ref>
Although less frequent, [[aortic sclerosis]] can be observed in middle-aged patients, and the risk of aortic sclerosis increases as the age in such a cohort increases.<ref name="pmid15670554">{{cite journal |author=Taylor HA, Clark BL, Garrison RJ, Andrew ME, Han H, Fox ER, Arnett DK, Samdarshi T, Jones DW |title=Relation of aortic valve sclerosis to risk of coronary heart disease in African-Americans |journal=[[The American Journal of Cardiology]] |volume=95 |issue=3 |pages=401–4 |year=2005 |month=February |pmid=15670554 |doi=10.1016/j.amjcard.2004.09.043 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9149(04)01611-X |accessdate=2012-04-10}}</ref><ref name="pmid19608594">{{cite journal |author=Stritzke J, Linsel-Nitschke P, Markus MR, Mayer B, Lieb W, Luchner A, Döring A, Koenig W, Keil U, Hense HW, Schunkert H |title=Association between degenerative aortic valve disease and long-term exposure to cardiovascular risk factors: results of the longitudinal population-based KORA/MONICA survey |journal=[[European Heart Journal]] |volume=30 |issue=16 |pages=2044–53 |year=2009 |month=August |pmid=19608594 |doi=10.1093/eurheartj/ehp287 |url=http://eurheartj.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=19608594 |accessdate=2012-04-10}}</ref>
 
Although rare, the prevalence of [[aortic sclerosis]] has been observed in middle-aged patients with an increase incidence observed as age advances.<ref name="pmid15670554">{{cite journal |author=Taylor HA, Clark BL, Garrison RJ, Andrew ME, Han H, Fox ER, Arnett DK, Samdarshi T, Jones DW |title=Relation of aortic valve sclerosis to risk of coronary heart disease in African-Americans |journal=[[The American Journal of Cardiology]] |volume=95 |issue=3 |pages=401–4 |year=2005 |month=February |pmid=15670554 |doi=10.1016/j.amjcard.2004.09.043 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9149(04)01611-X |accessdate=2012-04-10}}</ref><ref name="pmid19608594">{{cite journal |author=Stritzke J, Linsel-Nitschke P, Markus MR, Mayer B, Lieb W, Luchner A, Döring A, Koenig W, Keil U, Hense HW, Schunkert H |title=Association between degenerative aortic valve disease and long-term exposure to cardiovascular risk factors: results of the longitudinal population-based KORA/MONICA survey |journal=[[European Heart Journal]] |volume=30 |issue=16 |pages=2044–53 |year=2009 |month=August |pmid=19608594 |doi=10.1093/eurheartj/ehp287 |url=http://eurheartj.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=19608594 |accessdate=2012-04-10}}</ref>


==References==
==References==
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[[CME Category::Cardiology]]


[[Category:Disease]]
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[[Category:Cardiology]]

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2]

Overview

Aortic sclerosis is non-obstructive degeneration of the aortic valve that presents predominantly in patients over 65 years of age who have risk factors for coronary artery disease. Because aortic sclerosis is associated with coronary artery disease risk factors, it is also associated with a significant increase in the risk of cardiovascular death, myocardial infarction even in the absence of hemodynamically significant left ventricular outflow tract obstruction.[1][2][3]

Demographics

Age

Aortic sclerosis commonly affects those aged 65 years and over.[4][3][2][1]

In a large cohort study of 5,201 patients,[2] aortic sclerosis was present in ~37% patients > 75 years of age while aortic stenosis was seen only in 2.6% of patients > 75 years of age.[5] Aortic sclerosis was even more common in another study of 425 patients with a mean age of 68 +/- 15 years who presented to an emergency room with chest pain. The rate of aortic sclerosis in this study was 49%.[6]

Although less frequent, aortic sclerosis can be observed in middle-aged patients, and the risk of aortic sclerosis increases as the age in such a cohort increases.[7][8]

References

  1. ↑ 1.0 1.1 Lindroos M, Kupari M, Heikkilä J, Tilvis R (1993). "Prevalence of aortic valve abnormalities in the elderly: an echocardiographic study of a random population sample". Journal of the American College of Cardiology. 21 (5): 1220–5. PMID 8459080. Retrieved 2012-04-10. Unknown parameter |month= ignored (help)
  2. ↑ 2.0 2.1 2.2 Stewart BF, Siscovick D, Lind BK, Gardin JM, Gottdiener JS, Smith VE, Kitzman DW, Otto CM (1997). "Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study". Journal of the American College of Cardiology. 29 (3): 630–4. PMID 9060903. Retrieved 2012-04-10. Unknown parameter |month= ignored (help)
  3. ↑ 3.0 3.1 Otto CM, Lind BK, Kitzman DW, Gersh BJ, Siscovick DS (1999). "Association of aortic-valve sclerosis with cardiovascular mortality and morbidity in the elderly". The New England Journal of Medicine. 341 (3): 142–7. doi:10.1056/NEJM199907153410302. PMID 10403851. Retrieved 2012-04-10. Unknown parameter |month= ignored (help)
  4. ↑ Freeman RV, Otto CM (2005). "Spectrum of calcific aortic valve disease: pathogenesis, disease progression, and treatment strategies". Circulation. 111 (24): 3316–26. doi:10.1161/CIRCULATIONAHA.104.486738. PMID 15967862. Retrieved 2012-04-10. Unknown parameter |month= ignored (help)
  5. ↑ Aronow WS, Ahn C, Shirani J, Kronzon I (1999). "Comparison of frequency of new coronary events in older subjects with and without valvular aortic sclerosis". The American Journal of Cardiology. 83 (4): 599–600, A8. PMID 10073870. Retrieved 2012-04-10. Unknown parameter |month= ignored (help)
  6. ↑ Chandra HR, Goldstein JA, Choudhary N, O'Neill CS, George PB, Gangasani SR, Cronin L, Marcovitz PA, Hauser AM, O'Neill WW (2004). "Adverse outcome in aortic sclerosis is associated with coronary artery disease and inflammation". Journal of the American College of Cardiology. 43 (2): 169–75. PMID 14736432. Retrieved 2012-04-10. Unknown parameter |month= ignored (help)
  7. ↑ Taylor HA, Clark BL, Garrison RJ, Andrew ME, Han H, Fox ER, Arnett DK, Samdarshi T, Jones DW (2005). "Relation of aortic valve sclerosis to risk of coronary heart disease in African-Americans". The American Journal of Cardiology. 95 (3): 401–4. doi:10.1016/j.amjcard.2004.09.043. PMID 15670554. Retrieved 2012-04-10. Unknown parameter |month= ignored (help)
  8. ↑ Stritzke J, Linsel-Nitschke P, Markus MR, Mayer B, Lieb W, Luchner A, Döring A, Koenig W, Keil U, Hense HW, Schunkert H (2009). "Association between degenerative aortic valve disease and long-term exposure to cardiovascular risk factors: results of the longitudinal population-based KORA/MONICA survey". European Heart Journal. 30 (16): 2044–53. doi:10.1093/eurheartj/ehp287. PMID 19608594. Retrieved 2012-04-10. Unknown parameter |month= ignored (help)

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