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Published on: February 14, 2017
Global epidemiology of valvular heart disease
Sean Coffey1, Ross Roberts-Thomson2,3,4, Alex Brown3,4
1Department of Medicine - HeartOtago, University of Otago, Dunedin, New Zealand.
Insights
Valvular heart disease (VHD) affects millions globally, with rheumatic heart disease most common worldwide. Calcific aortic stenosis deaths are rising, necessitating updated clinical strategies and health policies.
Area of Science:
- Cardiology
- Epidemiology
- Public Health
Background:
- Valvular heart disease (VHD) significantly impacts physical function, quality of life, and longevity.
- Global VHD epidemiology shows a divide: degenerative VHD prevalent in high-income nations, and rheumatic heart disease (RHD) in low- and middle-income countries.
- RHD affects 41 million, while calcific aortic stenosis (CAS) and degenerative mitral valve disease affect 9 and 24 million, respectively.
Purpose of the Study:
- To examine the changing global epidemiology of VHD.
- To inform clinical practice advancements and health policy formulation.
- To discuss the global burden, geographical variations, and temporal trends of VHD.
Main Methods:
- Review of existing epidemiological data on VHD.
- Analysis of geographical variations in VHD presentation and management.
- Assessment of temporal trends in VHD disease burden.
Main Results:
- Rheumatic heart disease remains the most common VHD globally, affecting 41 million people.
- Calcific aortic stenosis and degenerative mitral valve disease affect 9 and 24 million, respectively.
- While RHD mortality decreased since 1900, CAS-related deaths have risen in the past 20 years.
Conclusions:
- Understanding the evolving global epidemiology of VHD is critical due to an aging population and therapeutic advancements.
- Geographical disparities in VHD prevalence and management require tailored health policies.
- Continued monitoring of VHD trends is essential for effective clinical practice and public health interventions.
Abstract:
Valvular heart disease (VHD) is a major contributor to loss of physical function, quality of life and longevity. The epidemiology of VHD varies substantially around the world, with a predominance of functional and degenerative disease in high-income countries, and a predominance of rheumatic heart disease in low-income and middle-income countries. Reflecting this distribution, rheumatic heart disease remains by far the most common manifestation of VHD worldwide and affects approximately 41 million people. By contrast, the prevalence of calcific aortic stenosis and degenerative mitral valve disease is 9 and 24 million people, respectively. Despite a reduction in global mortality related to rheumatic heart disease since 1900, the death rate has remained fairly static since 2000. Meanwhile, deaths from calcific aortic stenosis have continued to rise in the past 20 years. Epidemiological data on other important acquired and congenital forms of VHD are limited. An ageing population and advances in therapies make an examination of the changing global epidemiology of VHD crucial for advances in clinical practice and formulation of health policy. In this Review, we discuss the global burden of VHD, geographical variation in the presentation and clinical management, and temporal trends in disease burden.
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