Cardiovascular Risk Factors in Patients with Valvular Heart Disease: A Nationwide Observational Cohort Study

Area of Science:

• Cardiology
• Public Health
• Epidemiology

Background:

• Valvular heart disease (VHD) is a significant cardiovascular condition.
• Conventional cardiovascular risk factors are increasingly recognized as potential contributors to VHD development and progression.

Purpose of the Study:

• To investigate the prevalence of modifiable cardiovascular risk factors (smoking, hypertension, hyperlipidemia, diabetes) in patients with VHD.
• To assess the impact of these risk factors on patient outcomes.
• To identify prognostic indicators in VHD patients with varying risk factor burdens.

Main Methods:

• A cohort study involving 11,862 patients with moderate or greater VHD.
• Primary outcome: a composite of all-cause mortality, heart failure hospitalization, and myocardial infarction within two years.
• Analysis of risk factor distribution and their association with outcomes, stratified by VHD type and etiology.

Main Results:

• The study included 11,862 patients with VHD, with a mean age of 61.77 years and 44.4% females.
• Prevalence of risk factors: hypertension (45.0%), smoking (14.9%), diabetes (14.5%), and hyperlipidemia (13.4%).
• An increasing number of risk factors was independently associated with poorer two-year outcomes in patients with mitral regurgitation (MR), with a 17.3% higher risk of adverse events per additional risk factor in secondary MR. Females with three or four risk factors had poorer outcomes than males.

Conclusions:

• Over 20% of VHD patients had at least two conventional cardiovascular risk factors.
• The number of risk factors is a significant indicator of poor prognosis in patients with significant MR.
• Optimizing the management of cardiovascular risk factors is essential for improving secondary prevention and long-term outcomes in VHD patients.