Temporal trends in the prevalence and severity of aortic stenosis within a contemporary and diverse community-based cohort

Andrew P Ambrosy; Alan S Go; Thomas K Leong; Elisha A Garcia; Alex J Chang; Justin J Slade; Edward J McNulty; Jacob M Mishell; Andrew N Rassi; Ivy A Ku; David C Lange; Femi Philip; Benjamin Z Galper; Natalia Berry; Matthew D Solomon

doi:10.1016/j.ijcard.2023.04.047

Temporal trends in the prevalence and severity of aortic stenosis within a contemporary and diverse community-based cohort

Int J Cardiol. 2023 Aug 1:384:107-111. doi: 10.1016/j.ijcard.2023.04.047. Epub 2023 Apr 27.

Authors

Affiliations

¹ Department of Cardiology, Kaiser Permanente San Francisco Medical Center, San Francisco, CA, USA; Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA; Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA. Electronic address: andrew.p.ambrosy@kp.org.
² Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA; Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA; Departments of Epidemiology, Biostatistics and Medicine, University of California, San Francisco, San Francisco, CA, USA; Department of Medicine, Stanford University, Palo Alto, CA, USA.
³ Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
⁴ Department of Cardiology, Kaiser Permanente San Francisco Medical Center, San Francisco, CA, USA.
⁵ Department of Cardiology, Kaiser Permanente Santa Clara Medical Center, Santa Clara, CA, USA.
⁶ Department of Cardiology, Kaiser Permanente Sacramento Medical Center, Sacramento, CA, USA.
⁷ Department of Cardiology, Mid-Atlantic Permanente Medical Group, McLean, VA, USA.
⁸ Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA; Department of Cardiology, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA.

PMID: 37119944
DOI: 10.1016/j.ijcard.2023.04.047

Abstract

Background: Data on the epidemiology of aortic stenosis (AS) are primarily derived from single center experiences and administrative claims data that do not delineate by degree of disease severity.

Methods: An observational cohort study of adults with echocardiographic AS was conducted January 1st, 2013-December 31st, 2019 at an integrated health system. The presence/grade of AS was based on physician interpretation of echocardiograms.

Results: A total of 66,992 echocardiogram reports for 37,228 individuals were identified. The mean ± standard deviation (SD) age was 77.5 ± 10.5, 50.5% (N = 18,816) were women, and 67.2% (N = 25,016) were non-Hispanic whites. The age-standardized AS prevalence increased from 589 (95% Confidence Interval [CI] 580-598) to 754 (95% CI 744-764) cases per 100,000 during the study period. The age-standardized AS prevalences were similar in magnitude among non-Hispanic whites (820, 95% CI 806-834), non-Hispanic blacks (728, 95% CI 687-769), and Hispanics (789, 95% CI 759-819) and substantially lower for Asian/Pacific Islanders (511, 95% CI 489-533). Finally, the distribution of AS by degree of severity remained relatively unchanged over time.

Conclusions and relevance: The population prevalence of AS has grown considerably over a short timeframe although the distribution of AS severity has remained stable.

Keywords: Age; Aortic stenosis; Epidemiology; Ethnicity; Gender; Prevalence; Race.

Publication types

Observational Study

MeSH terms

Aged
Aged, 80 and over
Aortic Valve Stenosis* / diagnostic imaging
Aortic Valve Stenosis* / epidemiology
Asian American Native Hawaiian and Pacific Islander
Black or African American
Female
Hispanic or Latino
Humans
Male
Prevalence
United States
White