Prevalence and correlates of aortic valve sclerosis in hypertensive adults: the hypergen study

Abstract

Conclusions: Adequate blood pressure control seems to results in enhanced clinical or angiographic outcome in HP patients.Key Words: prognosis, coronary stenting Felizen S. Agno, Marcello Chinali, Jonathan N. Bella, Jennifer E. Liu, Donna K. Arnett, Dalane W. Kitzman, Albert Oberman, Paul N. Hopkins, DC Rao, Richard B. Devereux Aortic sclerosis (ASc) or aortic valve fibrocalcification with preserved leaflet mobility and antegrade Doppler velocity has been shown to be associated with atherosclerosis and an increased risk of all-cause and cardiovascular mortality. However, the prevalence and correlates of ASc among adults at high risk because of hypertension has not been defined in a population-based sample. Clinical and 2-dimensional echocardiographic parameters were measured in 1,557 hypertensive participants (65% women, 53Ϯ11 years of age, 65% black, 17% diabetic) without significant valvular disease or prevalent cardiovascular disease in the population-based HyperGEN study. Among the 1,557 participants, there were 137 (8.8%) with ASc. ASc was more prevalent in men than women (11.7% vs 7.2%), whites than blacks (14.1% vs 6.0%), and in participants with mild aortic regurgitation (18.9% vs 8.4%) (all pϽ0.05) but was not associated with diabetes, smoking or mild mitral regurgitation. Compared to participants without ASc, those with ASc had higher mean age (61.2Ϯ9.1 years vs 52.5Ϯ10.7 years), LDL cholesterol (131.3Ϯ37.8 vs 121.7Ϯ34.1 mg/dl), triglycerides (TG) (151.3Ϯ95.3 vs 134.1Ϯ88.0 mg/ dl), and pulse pressure (61.6Ϯ17.6 vs 57.5Ϯ16.0 mmHg) and lower body mass index (31.2Ϯ5.8 vs 32.3Ϯ7.2 g/m 2 ) and heart rate (66.7Ϯ11.4 vs 69.6Ϯ11.6 bpm) (all pϽ0.05). 2D/Doppler echocardiography revealed that patients with ASc had higher mean left ventricular (LV) mass/BSA (91.0Ϯ19.9 vs 86.0Ϯ18.0), relative wall thickness (RWT) (0.36Ϯ0.06 vs 0.35Ϯ0.05), systolic (1.44Ϯ0.14 vs 1.40Ϯ0.12 cm) and diastolic (0.92Ϯ0.13 vs 0.89Ϯ0.11cm) LV posterior wall thickness (PWT), isovolumic relaxation time (87.7Ϯ21.0 vs 81.6Ϯ16.7 msec), and lower MV E/A (0.88Ϯ0.25 vs 1.01Ϯ0.37) (all pϽ0.05). After controlling for age, gender, race, and heart rate, ASc was still independently associated with higher RWT (pϭ0.05) and systolic LVPWT (pϭ0.003). In conclusion, in a population-based sample adult, ASc among hypertensives was prevalent (8.8%) more in whites than blacks, was associated with proatherogenic clinical profile (older age, male gender, higher LDL and TG) and with LV concentric remodeling and impaired systolic and diastolic function, largely due to clinical covariates. Increased plasma concentrations of high sensitive C-Reactive Protein (CRP), is a widely used marker to monitor inflammatory states and predicts coronary heart disease in healthy subjects. Arterial stiffness is an important predictor of cardiovascular morbidity and mortality.The association of arterial stiffness and inflammation is not known. Therefore we hypothesized that CRP levels would have a direct relationship to arterial stiffness in apparently healthy individuals. OR-10 ...