Global epidemiology of valvular heart disease

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. KEY POINTS * The prevalence of valvular heart disease (VHD) is growing worldwide as a consequence of improved survival and the ageing population. * Rheumatic heart

disease (RHD) remains the most prevalent form of VHD and contributes to substantial premature mortality and reduced quality of life; RHD is primarily encountered in middle-income and

low-income countries and specific (usually indigenous) groups in high-income countries. * Calcific aortic valve disease is highly age-related, and its prevalence is increasing rapidly in

high-income countries. * Endocarditis is increasing in incidence and prevalence as a consequence of improved diagnosis and an ageing, susceptible population undergoing an increasing range

and complexity of medical interventions. * Valve abnormalities are a frequent component of congenital heart disease; bicuspid aortic valve is most commonly encountered, and its prevalence

seems to be uniform across the world. * Epidemiological information on patients who have undergone surgical or transcatheter valve intervention is limited, but this population is growing

exponentially (especially in high-income countries); forecasting trends is difficult owing to the rapid evolution of these interventions and of therapies that might reduce the need for

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Scholar  Download references AUTHOR INFORMATION Author notes * These authors contributed equally: Sean Coffey, Ross Roberts-Thomson. AUTHORS AND AFFILIATIONS * Department of Medicine –

HeartOtago, University of Otago, Dunedin, New Zealand Sean Coffey * Department of Cardiology, Royal Adelaide Hospital, Adelaide, SA, Australia Ross Roberts-Thomson * Aboriginal Health Equity

Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia Ross Roberts-Thomson & Alex Brown * University of Adelaide, Adelaide, SA, Australia Ross

Roberts-Thomson & Alex Brown * Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia and Perth Children’s Hospital, Perth, WA,

Australia Jonathan Carapetis * Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China Mao Chen * Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA Maurice

Enriquez-Sarano * Division of Paediatric Cardiology, Department of Paediatrics, Red Cross War Memorial Children’s Hospital, Faculty of Health Sciences University of Cape Town, Cape Town,

South Africa Liesl Zühlke * Division of Cardiology, Department of Medicine, Groote Schuur Hospital, Faculty of Health Sciences University of Cape Town, Cape Town, South Africa Liesl Zühlke *

Department of Cardiology, St Thomas’ Hospital, London, UK Bernard D. Prendergast Authors * Sean Coffey View author publications You can also search for this author inPubMed Google Scholar *

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