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Sex differences in the prevalence and risk factors for aortic valve calcification in the general population

Adeli, Athena ; Swahn, Eva ; Lind, Lars ; Soderberg, Stefan ; Blomberg, Anders ; Engström, Gunnar LU ; Östgren, Carl Johan ; Jernberg, Tomas ; Bergström, Göran and Settergren, Magnus , et al. (2026) In Heart
Abstract

Background Aortic valve calcification (AVC) is a disease process driven by inflammation and lipid infiltration, serving as a precursor to aortic stenosis. While male sex has been implicated as a risk factor for AVC, sex-specific differences, particularly among younger individuals in the general population, are not well characterised. Methods The Swedish CArdioPulmonary BioImage Study was used, comprising 30154 individuals between 50 and 64 years, randomly selected from the general population. Study participants were part of a prospective cohort and underwent laboratory tests, clinical examinations, comprehensive questionnaires and cardiac CT. Cardiac CT was used for determining presence of AVC. Logistic regression analysis was performed... (More)

Background Aortic valve calcification (AVC) is a disease process driven by inflammation and lipid infiltration, serving as a precursor to aortic stenosis. While male sex has been implicated as a risk factor for AVC, sex-specific differences, particularly among younger individuals in the general population, are not well characterised. Methods The Swedish CArdioPulmonary BioImage Study was used, comprising 30154 individuals between 50 and 64 years, randomly selected from the general population. Study participants were part of a prospective cohort and underwent laboratory tests, clinical examinations, comprehensive questionnaires and cardiac CT. Cardiac CT was used for determining presence of AVC. Logistic regression analysis was performed to assess associations between traditional cardiovascular risk factors and AVC. Results In total, 29160 participants were included and AVC was found in 1291 men (9%) and 730women (5%). Male sex was an independent predictor of AVC (OR 1.91; 95%CI 1.71 to 2.13). Characteristics associated with AVC were similar between the sexes. In the adjusted analyses, lipoprotein(a), hyperlipidaemia, hypertension and smoking were strongly associated with AVC, whereas low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, diabetes, glycated haemoglobin and estimated glomerular filtration rate showed no significant associations with AVC. Higher body mass index (BMI) was associated with AVC in men but not women. Conclusions Male sex was independently associated with AVC, and the prevalence of AVC was nearly twice as high in men as in women. Traditional cardiovascular risk factors, including lipoprotein(a), hyperlipidaemia, hypertension and smoking, were associated with AVC, with similar associations between sexes, except for BMI, which was associated with AVC in men but not in women.

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organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Aortic Valve Stenosis, Epidemiology
in
Heart
article number
heartjnl-2025-326468
publisher
BMJ Publishing Group
external identifiers
  • pmid:41611525
  • scopus:105029170405
ISSN
1355-6037
DOI
10.1136/heartjnl-2025-326468
language
English
LU publication?
yes
id
dd9aae69-b828-4936-ad14-4bb7bfeebcca
date added to LUP
2026-02-20 14:44:48
date last changed
2026-02-20 14:45:46
@article{dd9aae69-b828-4936-ad14-4bb7bfeebcca,
  abstract     = {{<p>Background Aortic valve calcification (AVC) is a disease process driven by inflammation and lipid infiltration, serving as a precursor to aortic stenosis. While male sex has been implicated as a risk factor for AVC, sex-specific differences, particularly among younger individuals in the general population, are not well characterised. Methods The Swedish CArdioPulmonary BioImage Study was used, comprising 30154 individuals between 50 and 64 years, randomly selected from the general population. Study participants were part of a prospective cohort and underwent laboratory tests, clinical examinations, comprehensive questionnaires and cardiac CT. Cardiac CT was used for determining presence of AVC. Logistic regression analysis was performed to assess associations between traditional cardiovascular risk factors and AVC. Results In total, 29160 participants were included and AVC was found in 1291 men (9%) and 730women (5%). Male sex was an independent predictor of AVC (OR 1.91; 95%CI 1.71 to 2.13). Characteristics associated with AVC were similar between the sexes. In the adjusted analyses, lipoprotein(a), hyperlipidaemia, hypertension and smoking were strongly associated with AVC, whereas low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, diabetes, glycated haemoglobin and estimated glomerular filtration rate showed no significant associations with AVC. Higher body mass index (BMI) was associated with AVC in men but not women. Conclusions Male sex was independently associated with AVC, and the prevalence of AVC was nearly twice as high in men as in women. Traditional cardiovascular risk factors, including lipoprotein(a), hyperlipidaemia, hypertension and smoking, were associated with AVC, with similar associations between sexes, except for BMI, which was associated with AVC in men but not in women.</p>}},
  author       = {{Adeli, Athena and Swahn, Eva and Lind, Lars and Soderberg, Stefan and Blomberg, Anders and Engström, Gunnar and Östgren, Carl Johan and Jernberg, Tomas and Bergström, Göran and Settergren, Magnus and Wang, Anne and Shahim, Bahira}},
  issn         = {{1355-6037}},
  keywords     = {{Aortic Valve Stenosis; Epidemiology}},
  language     = {{eng}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{Heart}},
  title        = {{Sex differences in the prevalence and risk factors for aortic valve calcification in the general population}},
  url          = {{http://dx.doi.org/10.1136/heartjnl-2025-326468}},
  doi          = {{10.1136/heartjnl-2025-326468}},
  year         = {{2026}},
}