Prevalence and correlates of aortic regurgitation in american indians: the Strong Heart Study

OBJECTIVES We sought to determine the prevalence and correlates of aortic regurgitation (AR) in a population-based sample group. BACKGROUND Concern over induction of AR by weight loss medication highlights the importance of assessing the prevalence and correlates of AR in unselected patient groups. METHODS Aortic regurgitation was assessed by color flow Doppler echocardiography in 3,501 American Indian participants age 47 to 81 years during the second Strong Heart Study. RESULTS Mild (1+) AR was present in 7.3%, 2+ AR in 2.4% and 3+ to 4+ AR in 0.3% of participants, more frequently in those ≥60 years old than in those <60 years old (14.4% vs. 5.8%, p < 0.001); AR was unrelated to gender. Compared with participants without AR, those with mild AR had a lower body mass index (p < 0.004) and higher systolic pressure (p < 0.003). Participants with AR had larger aortic root diameters (3.6 ± 0.4 vs. 3.4 ± 0.4 cm, p < 0.001), higher creatinine levels (1.3 ± 1.3 vs. 1.0 ± 1.0 mg/dl, p < 0.001) and higher urine albumin/creatinine levels (3.6 ± 2.3 vs. 3.3 ± 2.0 log, p < 0.001), as well as higher prevalences of aortic stenosis (AS) or mitral stenosis (MS) (p < 0.001). Regression analysis showed that AR was independently related to older age and larger aortic roots (p < 0.0001), AS and absence of diabetes (p = 0.002), MS (p = 0.003) and higher log urine albumin/creatinine (p = 0.005). CONCLUSIONS Aortic regurgitation occurred in 10% of a sample group of middle-aged to older adults and was related to older age, larger aortic root diameter, aortic and mitral stenosis and albuminuria. There was no association of AR with being overweight and a negative association of AR with diabetes.