Abstract
Introduction: Although non-rheumatic valvular heart diseases (NRVD) are common, there have been no studies to estimate their global burden. As part of the Global Burden of Disease (GBD) 2017 Study, we estimated the age and sex-specific number of deaths, prevalent cases, and disability-adjusted life years (DALYs) for calcific aortic valve disease (CAVD) and degenerative mitral valve disease (DMVD) for every country from 1990 to 2017. Methods: We used vital registration data, epidemiological survey data, and hospital claims data to estimate the cause-specific mortality rate, prevalence, and incidence of CAVD and DMVD using the GBD modelling framework. Results accounted for level of disease severity as well as the availability of valve repair or replacement procedures. Burden estimates for CAVD and DMVD were generated for each sex, 5-year age group, country, and year from 1990 to 2017. Results: We estimated 1.5M DALYs (1.3M to 1.7M) lost due to CAVD and 1.1M DALYs (0.8M to 1.4M) due to DMVD, globally, representing 0.12% (0.1% to 0.14%) of total lost health from all diseases in 2017. CAVD and DMVD caused 97.8K (75.0K to 104.8K) and 32.7K (28.5K to 38.2K) deaths, and 12.9M (11.5M to 14.2M) and 27.1M (26M to 27.1M) cases, respectively. The number of DALYs increased for both CAVD and DMVD between 1990 and 2017, by 123% (101% to 137%) and 64% (50% to 75%), respectively. There is large national and regional variation in the prevalence, mortality rate, and overall burden of these diseases, with the highest age-standardized rates estimated for high income countries. Conclusions: CAVD and DMVD are common diseases among the elderly. Health systems will need to consider improving prevention of CAVD and access to effective valve diagnostics and procedures if progress is to be made in addressing these treatable conditions.
Published Version
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