{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T07:15:50Z","timestamp":1763018150187,"version":"build-2065373602"},"reference-count":43,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2019,12,14]],"date-time":"2019-12-14T00:00:00Z","timestamp":1576281600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI15\/01983 and CIBERCV"],"award-info":[{"award-number":["PI15\/01983 and CIBERCV"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Hypercholesterolemia and statins are risk factors for aortic stenosis (AS) and vascular calcification, respectively. Whether heterozygous subjects with familial hypercholesterolemia (HeFH) treated with statins are at risk of AS is unknown. We study the prevalence of AS, aortic valve calcification (AoVC), and aortic sclerosis (ASc) in elderly subjects with HeFH in a prolonged statin treatment. Case-control study, cases were adults \u226565 years of age with a genetic diagnosis of HeFH, LDLc &gt;220 mg\/dl, and statin treatment \u22655 years. Controls were relatives of HeFH patients, with LDLc &lt;190 mg\/dl. Participants underwent a cardiac ultrasound for aortic valve analysis. We studied 205 subjects, 112 HeFH and 93 controls, with mean age 71.8(6.5) years and 70.0(7.3) years, respectively. HeHF, with respect to controls, presented greater gradients of aortic transvalvular pressure, 7.4(7.3) mmHg versus 5.0(2.8) mmHg, and maximum aortic velocity, 1.7(0.7) m\/s versus 1.5(0.4) m\/s, and lower aortic valve opening area, 2.0(0.7) cm2 versus 2.4(0.6) cm2 (all p &lt; 0.05). AoVC and ASc were also more prevalent in HeFH (p &lt; 0.05 between groups). Moderate\/severe AS prevalence was higher among HeFH: 7.1% versus 1.1% (age- and sex-adjusted odds ratio (OR) 8.33, p = 0.03). Independent risk factors for aortic valve disease in HeFH were age and LDLc before treatment. The number of years under statin treatment was not associated with any aortic valve measurement. Subjects \u226565 years with HeFH in prolonged statin treatment show more aortic valvular disease and higher frequency of AS than controls. Life-long elevated LDLc exposure, rather than time of exposure to statins, explains this higher risk.<\/jats:p>","DOI":"10.3390\/jcm8122209","type":"journal-article","created":{"date-parts":[[2019,12,16]],"date-time":"2019-12-16T05:19:38Z","timestamp":1576473578000},"page":"2209","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Aortic Valvular Disease in Elderly Subjects with Heterozygous Familial Hypercholesterolemia: Impact of Lipid-Lowering Therapy"],"prefix":"10.3390","volume":"8","author":[{"given":"Victoria","family":"Marco-Bened\u00ed","sequence":"first","affiliation":[{"name":"Lipid Unit, Hospital Universitario Miguel Servet, IIS Arag\u00f3n, CIBERCV, 50009 Zaragoza, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Laclaustra","sequence":"additional","affiliation":[{"name":"Lipid Unit, Hospital Universitario Miguel Servet, IIS Arag\u00f3n, CIBERCV, 50009 Zaragoza, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan M.","family":"Casado-Dominguez","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosa","family":"Villa-Pobo","sequence":"additional","affiliation":[{"name":"Lipid Unit, Hospital Universitario Miguel Servet, IIS Arag\u00f3n, CIBERCV, 50009 Zaragoza, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roc\u00edo","family":"Mateo-Gallego","sequence":"additional","affiliation":[{"name":"Lipid Unit, Hospital Universitario Miguel Servet, IIS Arag\u00f3n, CIBERCV, 50009 Zaragoza, Spain"},{"name":"Universidad de Zaragoza, 50009 Zaragoza, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosa M.","family":"S\u00e1nchez-Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Endocrinology Department, Hospital Insular de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Blanco Nuez","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Universitario Dr. Negr\u00edn, 35012 Las Palmas de Gran Canaria, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2217-8905","authenticated-orcid":false,"given":"Emilio","family":"Ortega-Mart\u00ednez de Victoria","sequence":"additional","affiliation":[{"name":"Lipid Clinic, Hospital Clinic, CIBEROBN, 08036 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Sitges","sequence":"additional","affiliation":[{"name":"Lipid Clinic, Hospital Clinic, CIBEROBN, 08036 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan","family":"Pedro-Botet","sequence":"additional","affiliation":[{"name":"Lipid Unit, Hospital del Mar, 08003 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose","family":"Puzo","sequence":"additional","affiliation":[{"name":"Universidad de Zaragoza, 50009 Zaragoza, Spain"},{"name":"Lipid Unit, Hospital San Jorge, 22004 Huesca, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teresa","family":"Villarroel","sequence":"additional","affiliation":[{"name":"Lipid Unit, Hospital San Jorge, 22004 Huesca, Spain"},{"name":"Cardiology Department, Hospital San Jorge, 22004 Huesca, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7043-0952","authenticated-orcid":false,"given":"Fernando","family":"Civeira","sequence":"additional","affiliation":[{"name":"Lipid Unit, Hospital Universitario Miguel Servet, IIS Arag\u00f3n, CIBERCV, 50009 Zaragoza, Spain"},{"name":"Universidad de Zaragoza, 50009 Zaragoza, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2019,12,14]]},"reference":[{"key":"ref_1","unstructured":"Scriver, C.R. 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