Results from the PREVUE-VALVE study suggest that there are currently at least 4.7 million people aged 65-85 living with moderate or greater valvular heart disease (VHD) in the United States, and at least 10.6 million with clinically significant VHD, most of whom are unaware of their condition. The prevalence of VHD increases sharply with advanced age-a finding that suggests a need for screening and treatment programs to ensure broad access to appropriate care.
Findings were reported today at TCT® 2025, the annual scientific symposium of the Cardiovascular Research Foundation® (CRF®). TCT is the world's premier educational meeting specializing in interventional cardiovascular medicine.
Although patients with VHD may experience symptoms such as shortness of breath and fatigue, many patients may be asymptomatic, which may lead to delay in diagnosis and treatment. The incidence of VHD is increasing in the United States and other parts of the world. According to the American Heart Association, nearly 25,000 Americans die from VHD each year.
For the PREVUE-VALVE study, older individuals (ages 65-85) were recruited from retail pharmacies throughout the United States. After an initial study screening, a total of 3,000 people received an at-home visit during which a 12-lead electrocardiogram and a formal echocardiogram were performed. Blood samples (upon patient consent) and standardized health status assessments were also collected. Electrocardiogram and echocardiogram assessments (including diagnosis and assessment of severity of VHD) were performed by independent core laboratories.
The primary endpoint was the population prevalence of moderate or greater VHD and its individual components including aortic stenosis, aortic regurgitation, mitral stenosis, mitral regurgitation or tricuspid regurgitation. The study found that the overall prevalence of moderate or greater VHD was 8.2% (95% CI 7.0-9.5%). The prevalence increased with advanced age (5.1% in patients 65-69, 7.0% for 70-74, 10.5% for 75-79 and 14.7% for 80-85 years of age). Tricuspid regurgitation (3.7%) was the most common type of VHD followed by aortic stenosis (3.1%), mitral regurgitation (2.0%) and aortic regurgitation (0.7%).
When study participants with mild to moderate VHD were also included, the overall prevalence increased to 18.4% (95% CI 16.7-20.2%) with the rate also increasing with age (31.4% in the 80-85 cohort compared with 12.1% for 65-69 years of age). Tricuspid regurgitation was also the most common type of VHD (10.7%) when including mid-moderate disease. A further analysis using census data from the United States suggested that at least 4.7 million people between the ages of 65-85 are living with moderate or greater VHD, and at least 10.6 million have greater than mild VHD. Based on current census projections, the absolute prevalence of moderate or greater VHD is projected to increase by about 1.8 million by 2060, driven largely by a 74% increase among the 80–85-year-old age group.
The study also found that age-adjusted and sex-adjusted prevalence of VHD is approximately 20% lower among Black versus White individuals in the United States, driven largely by lower rates of aortic valve disease. These findings have important implications for efforts to improve access to minority patients with VHD across the US.
"Many patients with VHD remain untreated due to inadequate access to appropriate care or are treated later than recommended due to a late diagnosis," said David Cohen, MD MSc, Director of Clinical and Outcomes Research at the Cardiovascular Research Foundation and Director of Academic Affairs at St. Francis Hospital & Heart Center in Roslyn, New York.
These findings clearly show that the prevalence of these conditions is substantial and will continue to grow over the next several decades as the population continues to age. In addition, they have important public health implications that should inform the design of future studies to help us develop tools to more effectively screen and diagnose patients with VHD and ultimately ensure broad access to treatment."
David Cohen, St. Francis Hospital & Heart Center
The study was an investigator-initiated study sponsored by the Cardiovascular Research Foundation funded by investigator-initiated grants from Abbott, Edwards Lifesciences, and Philips.
Dr. Cohen reported receiving grant support from Edwards Lifesciences, Medtronic, Corvia, I-Rhythm, Cathworks, Abbott Vascular, Boston Scientific, Phillips, Zoll/Therox and JenaValve. He also disclosed consulting/advisory boards with Edwards Lifesciences, Boston Scientific, Zoll Medical, Medtronic, Abbott Vascular and Elixir Medical.
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