Abstract 18258: Mild Aortic Regurgitation and Increased Risk of Incident Heart Failure among Community-Dwelling Older Adults: Findings from a Prospective Population Study
Background: Mild aortic regurgitation (AR) is common in older adults, often attributed to aging and is considered harmless. We studied if baseline mild AR is associated with incident HF among community—dwelling adults ≥65 years in the Cardiovascular Health Study (CHS).
Methods: In the original CHS cohort, 4895 participants were free of prevalent HF at baseline, of whom 4873 had echocardiographic data on type and grade of valvular heart disease (VHD). Of these, 372 (8%) had mild AR (AR jet height to left ventricular outflow tract diameter ratio <24%). After excluding those with moderate (n=505), moderately severe (n=36) or severe (n=16) AR, the final sample size was 4316. We used propensity scores for mild AR, estimated for each of the 4316 participants, to match 353 (95% of 372) of those with mild AR with 1048 of those without AR, thus assembling a cohort of 1401 participants who were balanced on 56 baseline traditional cardiovascular risk factors including hypertension and blood pressure, and other types and grades of VHD. Cox regression models were used to estimate association of mild AR with incident HF.
Results: Participants (n=1401) had a mean (±SD) age of 74 (±6) years, 48% were women, and 4% African American. Among the 4316 pre-match participants, incident HF occurred in 29% and 19% of those with AR and no-AR respectively during >12 years of follow-up (unadjusted HR, 1.78; 95% CI, 1.45–2.18; p<0.001). Among matched participants, incident HF occurred in 27% and 21% of those with mild AR and no-AR respectively (matched HR, 1.40; 95% CI, 1.10–1.78; p=0.006; Figure). There was no significant interaction between mild AR and sex (unadjusted and matched p for Cox-regression-based interaction, 0.278 and 0.909 and respectively).
Conclusions: In community-dwelling older adults free of baseline HF, mild AR was associated with a significant increased risk of incident HF, independent of other cardiovascular risk factors and other types and grades of VHD.
- © 2010 by American Heart Association, Inc.