High BMI, lipoprotein(a) levels up risk of calcific aortic valve disease

The combination of extremely high lipoprotein(a) levels and body mass index (BMI) results in a 3.5-fold increased risk of calcific aortic valve disease (CAVD), according to a recent study. The 10-year absolute risk of CAVD by categories of lipoprotein(a) levels, BMI, age, and sex ranges from 0.4 percent to 14 percent.

A team of investigators used information on 69,988 randomly selected individuals recruited from 2003 to 2015 from the Copenhagen General Population Study to examine the association between high lipoprotein(a) and high BMI with the risk of CAVD.

When compared to individuals in the 1st to 49th percentiles for both lipoprotein(a) and BMI, the multivariable adjusted hazard ratios for CAVD were 1.6 (95 percent confidence interval [CI], 1.3‒1.9) for the 50th to 89th percentiles (16 percent of all individuals) and 3.5 (95 percent CI, 2.5‒5.1) for the 90th to 100th percentiles (1.1 percent of all individuals; p_interaction=0.92).

The 10-year absolute risk of CAVD rose with higher lipoprotein(a), BMI, and age and was greater in men than in women. In women and men aged 70‒79 years, the 10-year absolute risks were 5 percent and 8 percent for lipoprotein(a) ≤42 mg/dL (88 nmol/L), 7 percent and 11 percent for 42–79 mg/dL (89-169 nmol/L), and 9 percent and 14 percent for lipoprotein(a) ≥80 mg/dL (170 nmol/L), respectively.

“High plasma lipoprotein(a) and high BMI are both causal risk factors for CAVD,” the investigators said.