{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T15:58:01Z","timestamp":1790611081926,"version":"4.1.0"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Risk factors for developing heart valve and ascending aortic disease are based mainly on retrospective data. To elucidate these factors in a prospective manner, we have performed a nested case\u2013referent study using data from large, population\u2010based surveys.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">A total of 777 patients operated for heart valve disease or disease of the ascending aorta had previously participated in population\u2010based health surveys in Northern Sweden. Median time (interquartile range) from survey to surgery was 10.5 (9.0) years. Primary indications for surgery were aortic stenosis (41%), aortic regurgitation (12%), mitral regurgitation (23%), and dilatation\/dissection of the ascending aorta (17%). For each case, referents were allocated, matched for age, sex, and geographical area. In multivariable models, surgery for aortic stenosis was predicted by hypertension, high cholesterol levels, diabetes mellitus, and active smoking. Surgery for aortic regurgitation was associated with a low cholesterol level, whereas a high cholesterol level predicted surgery for mitral regurgitation. Hypertension, blood pressure, and previous smoking predicted surgery for disease of the ascending aorta whereas diabetes mellitus was associated with reduced risk. After exclusion of cases with coronary atherosclerosis, only the inverse associations between cholesterol and aortic regurgitation and between diabetes mellitus and disease of the ascending aorta remained.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">This is the first truly prospective study of traditional cardiovascular risk factors and their association with valvular heart disease and disease of the ascending aorta. We confirm the strong association between traditional risk factors and aortic stenosis, but only in patients with concomitant coronary artery disease. In isolated valvular heart disease, the impact of traditional risk factors is varying.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.116.005133","type":"journal-article","created":{"date-parts":[[2017,5,5]],"date-time":"2017-05-05T20:10:21Z","timestamp":1494015021000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":36,"title":["Traditional Cardiovascular Risk Factors and Their Relation to Future Surgery for Valvular Heart Disease or Ascending Aortic Disease: A\u00a0Case\u2013Referent Study"],"prefix":"10.1161","volume":"6","author":[{"given":"Johan","family":"Ljungberg","sequence":"first","affiliation":[{"name":"Ume\u00e5 University","place":["Ume\u00e5, Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bengt","family":"Johansson","sequence":"additional","affiliation":[{"name":"Ume\u00e5 University","place":["Ume\u00e5, Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl Gunnar","family":"Engstr\u00f6m","sequence":"additional","affiliation":[{"name":"Ume\u00e5 University","place":["Ume\u00e5, Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elin","family":"Albertsson","sequence":"additional","affiliation":[{"name":"Ume\u00e5 University","place":["Ume\u00e5, Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Holmer","sequence":"additional","affiliation":[{"name":"Ume\u00e5 University","place":["Ume\u00e5, Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margareta","family":"Norberg","sequence":"additional","affiliation":[{"name":"Ume\u00e5 University","place":["Ume\u00e5, Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingvar A.","family":"Bergdahl","sequence":"additional","affiliation":[{"name":"Ume\u00e5 University","place":["Ume\u00e5, Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"S\u00f6derberg","sequence":"additional","affiliation":[{"name":"Ume\u00e5 University","place":["Ume\u00e5, Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1177\/2047487312451238","article-title":"Prevalence of calcific aortic valve disease in the elderly and associated risk factors: a population\u2010based study in a Mediterranean area","volume":"20","author":"Ferreira\u2010Gonzalez I","year":"2013","unstructured":"Ferreira\u2010Gonzalez I, Pinar\u2010Sopena J, Ribera A, Marsal JR, Cascant P, Gonzalez\u2010Alujas T, Evangelista A, Brotons C, Moral I, Permanyer\u2010Miralda G, Garcia\u2010Dorado D, Tornos P. 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