The calcified aortic valve lesion develops in the setting of endothelial injury and inflammation and displays hallmarks of atherosclerosis, including lipids accumulation, matrix metalloproteinase activation, and interaction with renin-angiotensin system. Current evidence indicates that modification of atherosclerotic risk factors will slow the progression of aortic valve calcification, and valve risk factors should be addressed in all patients who have aortic valve calcification.