Higher ambulatory blood pressure is associated with aortic valve calcification in the elderly

A population-based study

Shinichi Iwata, Cesare Russo, Zhezhen Jin, Joseph E. Schwartz, Shunichi Homma, Mitchell S V Elkind, Tatjana Rundek, Ralph L Sacco, Marco R. Di Tullio

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Aortic valve calcification (AVC) without outflow obstruction (stenosis) is common in the elderly and increases the risk of cardiovascular morbidity and mortality. Although high blood pressure (BP) measured at the doctor's office is known to be associated with AVC, little is known about the association between 24-hour ambulatory BP (ABP) and AVC. Our objective was to clarify the association between ABP variables and AVC. The study population consisted of 737 patients (mean age, 71±9 years) participating in the Cardiovascular Abnormalities and Brain Lesions study who underwent 24-hour ABP monitoring. Each aortic valve leaflet was graded on a scale of 0 (normal) to 3 (severe calcification). A total valve score (values 0-9) was calculated as the sum of all leaflet scores. Advanced AVC (score 4) was present in 77 subjects (10.4%). All of the systolic ABP variables (except systolic BP nocturnal decline) and mean asleep diastolic BP were positively associated with advanced calcification, whereas normal dipping status and diastolic BP nocturnal decline were negatively associated. Multiple regression analysis indicated that mean awake diastolic BP (odds ratio, 1.31 [95% CI, 1.01-1.71]) and asleep diastolic BP (odds ratio, 1.34 [95% CI, 1.04-1.72]) remained independently associated with advanced calcification after adjustment for age, sex, cigarette smoking, diabetes mellitus, hypercholesterolemia, hypertension, serum creatinine, and any degree of aortic insufficiency. Diastolic ABP is independently associated with advanced calcification. This finding may have important implications in gaining further insight into the mechanism of AVC.

Original languageEnglish
Pages (from-to)55-60
Number of pages6
JournalHypertension
Volume61
Issue number1
DOIs
StatePublished - Jan 1 2013

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Blood Pressure
Hypertension
Population
Odds Ratio
Calcification of Aortic Valve
Cardiovascular Abnormalities
Ambulatory Monitoring
Hypercholesterolemia
Aortic Valve
Creatinine
Diabetes Mellitus
Arterial Pressure
Pathologic Constriction
Smoking
Regression Analysis
Morbidity
Mortality
Brain
Serum

Keywords

  • ambulatory blood pressure
  • aortic valve calcification

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Iwata, S., Russo, C., Jin, Z., Schwartz, J. E., Homma, S., Elkind, M. S. V., ... Di Tullio, M. R. (2013). Higher ambulatory blood pressure is associated with aortic valve calcification in the elderly: A population-based study. Hypertension, 61(1), 55-60. https://doi.org/10.1161/HYPERTENSIONAHA.112.202697

Higher ambulatory blood pressure is associated with aortic valve calcification in the elderly : A population-based study. / Iwata, Shinichi; Russo, Cesare; Jin, Zhezhen; Schwartz, Joseph E.; Homma, Shunichi; Elkind, Mitchell S V; Rundek, Tatjana; Sacco, Ralph L; Di Tullio, Marco R.

In: Hypertension, Vol. 61, No. 1, 01.01.2013, p. 55-60.

Research output: Contribution to journalArticle

Iwata, Shinichi ; Russo, Cesare ; Jin, Zhezhen ; Schwartz, Joseph E. ; Homma, Shunichi ; Elkind, Mitchell S V ; Rundek, Tatjana ; Sacco, Ralph L ; Di Tullio, Marco R. / Higher ambulatory blood pressure is associated with aortic valve calcification in the elderly : A population-based study. In: Hypertension. 2013 ; Vol. 61, No. 1. pp. 55-60.
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