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Valvular Heart Diseases in Swedish Males and Females: A National Cohort Study

Per Wändell1, Xinjun Li2, Axel C Carlsson3

  • 1Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden; Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.

JACC. Advances
|March 21, 2026
PubMed

Insights

Males have a higher incidence of valvular heart disease, but specific valve disorder risks vary by sex. Further research is needed to understand these sex differences in heart conditions.

Area of Science:

  • Cardiology
  • Public Health
  • Epidemiology

Background:

  • Sex differences in valvular heart diseases are understudied, particularly using nationwide data.
  • Previous research has not comprehensively analyzed sex-based risks for various valvular heart conditions.

Purpose of the Study:

  • To investigate the risk of different valvular heart diseases in males versus females.
  • To conduct a comprehensive, nationwide analysis of sex-based disparities in valvular heart disease incidence in Sweden.

Main Methods:

  • Nationwide Swedish study of nearly 10 million individuals (1998-2018).
  • Valvular heart disease diagnoses identified from the National Patient Register.
  • Cox regression analysis adjusted for age, comorbidities, and sociodemographic factors to estimate hazard ratios (HRs).

Main Results:

  • Overall incidence rates of valvular heart disease were higher in males (68.6 per 100,000 person-years) than females (51.3 per 100,000 person-years).
  • Males had lower HRs for rheumatic mitral and tricuspid valve disorders, and pulmonary valve disorders.
  • Males had higher HRs for nonrheumatic mitral and aortic valve disorders, and nonrheumatic tricuspid valve disorders compared to females.

Conclusions:

  • Significant sex differences exist in valvular heart disease incidence and specific valve disorder risks.
  • Males generally exhibit higher incidence rates of valvular heart disease diagnoses.
  • The etiological factors contributing to observed sex differences in valvular heart disease remain to be elucidated.
Abstract

Keywords:
immigrantsneighborhoodrheumatic valvular heart diseasesexsocioeconomic statusvalvular heart disease

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