Burden of Valvular Heart Diseases in a Racially and Ethnically Diverse Population: The Bronx-Valve Registry

Area of Science:

• Cardiovascular Medicine
• Epidemiology
• Health Disparities

Background:

• Valvular heart disease (VHD) is a significant cardiovascular condition with limited data on its prevalence and impact across racial and ethnic minority groups.
• Understanding VHD burden in diverse populations is crucial for equitable healthcare and targeted interventions.

Purpose of the Study:

• To assess the prevalence and clinical correlates of valvular heart disease (VHD) in a highly diverse urban population in the United States.
• To identify variations in VHD burden and characteristics among different racial and ethnic groups.

Main Methods:

• Retrospective analysis of adult echocardiograms performed between January 2010 and December 2019 at a quaternary care health system in the Bronx, New York.
• Inclusion of 80,584 individuals diagnosed with native VHD, with stratification by race and ethnicity (non-Hispanic Black, non-Hispanic White, Asian, Hispanic).
• Assessment of VHD prevalence, age-related trends, comorbidities, and specific valve involvement across demographic groups.

Main Results:

• VHD prevalence increases with age across all racial and ethnic groups.
• Non-Hispanic Black, Asian, and Hispanic individuals were younger at diagnosis and presented with a higher burden of comorbidities compared to non-Hispanic White individuals.
• Tricuspid and mitral regurgitation were the most prevalent VHD types in older adults (≥75 years). Non-Hispanic White individuals had higher rates of tricuspid regurgitation, mitral regurgitation, and multiple VHDs, but younger non-Hispanic Black individuals (<65 years) showed higher frequencies of these conditions.

Conclusions:

• The Bronx-Valve Registry confirms a high burden of VHD that escalates with age and exhibits significant variation among racial and ethnic groups.
• Racial and ethnic minorities diagnosed with VHD are generally younger and have a greater comorbidity burden, indicating potential disparities in diagnosis and management.
• Implementation of targeted resources and strategies is essential to mitigate racial and ethnic disparities in VHD diagnosis and cardiovascular risk factor management, promoting health equity.