Aortic valve calcification in hypertensive patients: Prevalence, risk factors and association with transvalvular flow velocity

Alexander Tenenbaum*, Enrique Z. Fisman, Ehud Schwammenthal, Yehuda Adler, Joseph Shemesh, Yaniv Sherer, Michael Motro

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: The important role of the "nonobstructive" aortic valve calcification (AVC) in cardiovascular morbidity and mortality has recently been emphasized. The present work had two goals: (1) to analyze the prevalence and factors determining the extent of AVC in hypertensive patients; (2) to investigate a possible association between the extent of AVC and flow velocity across the aortic valve. Methods: This was a prospective study performed in a university hospital. The sample included 263 consecutive patients (139 men and 124 women), mean age 65 ± 6, who underwent echo-Doppler. The upper quartile of peak flow velocity across the aortic valve (> 130 mm/s in our population) was defined as augmented flow velocity. Results: There were 31 (12%) patients in the advanced AVC group and 122 (46%) without any calcified deposits (the no AVC group). The remaining 110 (42%), who did not meet criteria for advanced AVC, comprised the trivial AVC group. Peak flow velocity was significantly higher in patients with advanced vs. trivial AVC and no AVC groups: 135 ± 45, 116 ± 23 and 113 ± 23 cm/s, respectively; p = 0.0002. Prevalence of augmented transvalvular aortic flow was significantly higher (p = 0.01) among patients with advanced AVC (41.9%) vs. trivial (20.9%) and no AVC (20.5%). Multivariate analyses identified age as the only independent variable associated with advanced AVC [OR 1.6 (CI 1.2-2.3), 5 years increment]. Advanced AVC and female gender were identified as independent variables for augmented transvalvular aortic flow with OR 2.9 (CI 1.3-6.4) and 2.5 (CI 1.4-4.6), respectively. Conclusions: Prevalence of AVC among hypertensive patients is high and clearly age-related. Female gender and advanced (but not trivial) AVC are associated with augmented aortic transvalvular peak flow. Our results stress the role of protruding calcium deposits in augmentation of rest flow velocity across the aortic valve regardless of visible restriction of leaflet opening.

Original languageEnglish
Pages (from-to)7-13
Number of pages7
JournalInternational Journal of Cardiology
Issue number1
StatePublished - Mar 2004


  • Aortic valve
  • Blood flow
  • Calcium
  • Echocardiography


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