Prevalence and common cardiovascular risk factors in aortic valve calcification in the middle-aged general population

Aortic valve calcification (AVC) is an underlying pathophysiological mechanism for aortic stenosis, the most common valvular heart disease requiring intervention in developed countries. Aortic valve calcification is common in the elderly but less is known in younger individuals. We therefore sought to examine the prevalence and associated characteristics of AVC among the middle-aged population using the Swedish CardioPulmonary BioImage Study (SCAPIS), comprising 30 154 randomly selected men and women aged 50-64 years. Study participants underwent cardiac computed tomography for the assessment of AVC.Aortic valve calcification was concerningly common in the middle-aged population at 3, 7, and 11% among the age groups 50-54, 55-59, and 60-64 years, respectively. Moreover, AVC was found more frequently among those with cardiovascular risk factors or established cardiovascular disease. Six common and modifiable cardiovascular risk factors (smoking, hypertension, hyperlipidaemia, diabetes, body mass index, and kidney dysfunction) contributed to approximately a third of AVC cases.Given that a substantial proportion of middle-aged individuals are affected with AVC, the study results may serve as a basis for future screening initiatives for a subgroup of individuals at highest risk in the general population. Furthermore, this emphasizes the potential of optimizing risk factor management to reduce the burden of AVC.