Global, Regional, and National Burden of Calcific Aortic Valve and Degenerative Mitral Valve Diseases, 1990–2017
Yadgir, SimonInstitute for Health Metrics and Evaluation (S.Y., C.O.J., C.M.B., S.I.H., A.H.M., M.R.N., G.A.R.), University of Washington, Seattle.
Johnson, Catherine OwensInstitute for Health Metrics and Evaluation (S.Y., C.O.J., C.M.B., S.I.H., A.H.M., M.R.N., G.A.R.), University of Washington, Seattle.
Aboyans, VictorInstitute of Epidemiology, University of Limoges, France (V. Aboyans).
Adebayo, Oladimeji M.College of Medicine, University College Hospital, College of Medicine, University College Hospital, Ibadan, Oyo, Nigeria (O.M.A.).
Adedoyin, Rufus AdesojiDepartment of Medical Rehabilitation, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria (R.A.A.).
Afarideh, MohsenEndocrinology and Metabolism Research Center (M.A., A.E.), Tehran University of Medical Sciences, Iran.
Alahdab, FaresEvidence Based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, MN (F.A.).
Alashi, AlaaDepartment of Cardiovascular Medicine (A.A., M.M.G.), Cleveland Clinic, OH.
Alipour, VahidHealth Economics Department (V. Alipour), Iran University of Medical Sciences, Tehran.
Arabloo, JalalHealth Management and Economics Research Center (V. Alipour, J.A., S.A., A. Rezapour), Iran University of Medical Sciences, Tehran.
Azari, SamadHealth Management and Economics Research Center (V. Alipour, J.A., S.A., A. Rezapour), Iran University of Medical Sciences, Tehran.
Barthelemy, Celine M.Institute for Health Metrics and Evaluation (S.Y., C.O.J., C.M.B., S.I.H., A.H.M., M.R.N., G.A.R.), University of Washington, Seattle.
Naghibi Irvani, Seyed SinaResearch Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran (S.S.N.I.).
Jürisson, MikkInstitute of Family Medicine and Public Health, University of Tartu, Tartumaa, Estonia (M.J.).
Kasaeian, AmirHematologic Malignancies Research Center (A. Kasaeian), Tehran University of Medical Sciences, Iran.
Kengne, Andre PascalDepartment of Medicine, University of Cape Town, South Africa (A.P.K., G.A.M., K.S.).
Khan, Abdur RahmanDivision of Cardiovascular Medicine, University of Louisville, KY (T.A.F., A.R.K.).
Kisa, AdnanDepartment of Health Services Policy and Management, University of South Carolina, Columbia (A. Kisa).
Kisa, SezerDepartment of Nursing and Health Promotion, Oslo Metropolitan University, Norway (S.K.).
Kolte, DhavalDepartment of Medicine, Brown University, Providence, RI (D.K.).
Manafi, NavidOphthalmology Department, University of Manitoba, Winnipeg, Canada (N.M.).
Manafi, AmirDepartment of Surgery, University of Virginia, Charlottesville (A.M.).
Mensah, George A.Center for Translation Research and Implementation Science, National Institutes of Health, Bethesda, MD (G.A.M.).
Mirrakhimov, Erkin M.Department of Atherosclerosis and Coronary Heart Disease, National Center of Cardiology and Internal Disease, Bishkek, Kyrgyzstan (E.M.M.).
Mohammad, YousefInternal Medicine Department, King Saud University, Riyadh, Saudi Arabia (Y.M.).
Mokdad, Ali H.Department of Health Metrics Sciences (A.H.M., G.A.R.), University of Washington, Seattle.
Negoi, Ruxandra IrinaDepartment of Cardiology, Cardio-Aid, Bucharest, Romania (R.I.N.).
Thi Nguyen, Huong LanInstitute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam (H.L.T.N.).
Nguyen, Trang HuyenCenter of Excellence in Behavioral Health, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam (T.H.N.).
Nixon, Molly R.Institute for Health Metrics and Evaluation (S.Y., C.O.J., C.M.B., S.I.H., A.H.M., M.R.N., G.A.R.), University of Washington, Seattle.
Otto, Catherine M.Division of Cardiology (C.M.O., G.A.R.), University of Washington, Seattle.
Patel, ShantiDepartment of Medicine, Maimonides Medical Center, Brooklyn, NY (S.P.).
Pilgrim, ThomasDepartment of Cardiology, University of Bern, Switzerland (T.P.).
English Background: Nonrheumatic valvular diseases are common; however, no studies have estimated their global or national burden. As part of the Global Burden of Disease Study 2017, mortality, prevalence, and disability-adjusted life-years (DALYs) for calcific aortic valve disease (CAVD), degenerative mitral valve disease, and other nonrheumatic valvular diseases were estimated for 195 countries and territories from 1990 to 2017.
Methods: Vital registration data, epidemiologic survey data, and administrative hospital data were used to estimate disease burden using the Global Burden of Disease Study modeling framework, which ensures comparability across locations. Geospatial statistical methods were used to estimate disease for all countries, because data on nonrheumatic valvular diseases are extremely limited for some regions of the world, such as Sub-Saharan Africa and South Asia. Results accounted for estimated level of disease severity as well as the estimated availability of valve repair or replacement procedures. DALYs and other measures of health-related burden were generated for both sexes and each 5-year age group, location, and year from 1990 to 2017.
Results: Globally, CAVD and degenerative mitral valve disease caused 102 700 (95% uncertainty interval [UI], 82 700–107 900) and 35 700 (95% UI, 30 500–42 500) deaths, and 12.6 million (95% UI, 11.4 million–13.8 million) and 18.1 million (95% UI, 17.6 million–18.6 million) prevalent cases existed in 2017, respectively. A total of 2.5 million (95% UI, 2.3 million–2.8 million) DALYs were estimated as caused by nonrheumatic valvular diseases globally, representing 0.10% (95% UI, 0.09%–0.11%) of total lost health from all diseases in 2017. The number of DALYs increased for CAVD and degenerative mitral valve disease between 1990 and 2017 by 101% (95% UI, 79%–117%) and 35% (95% UI, 23%–47%), respectively. There is significant geographic variation in the prevalence, mortality rate, and overall burden of these diseases, with highest age-standardized DALY rates of CAVD estimated for high-income countries.
Conclusions: These global and national estimates demonstrate that CAVD and degenerative mitral valve disease are important causes of disease burden among older adults. Efforts to clarify modifiable risk factors and improve access to valve interventions are necessary if progress is to be made toward reducing, and eventually eliminating, the burden of these highly treatable diseases.