Abstract
BackgroundThe epidemiology of valvular heart disease (VHD) has changed markedly over the last 50 years worldwide, and the prevalence and features of VHD in China are unknown. The objective of this study was to investigate the current status and etiology of VHD in China.MethodsWe used a cross-sectional national survey with stratified multistage random sampling from the general Chinese population to estimate the VHD burden. Data on demographic characteristics, medical history, physical examination, blood tests, and potential etiology were collected. Echocardiography was used to detect VHD.ResultsThe national survey enrolled 34,994 people aged 35 years or older across China. Overall, 31,499 people were included in the final analysis, and 1309 participants were diagnosed with VHD. The weighted prevalence was 3.8%, with an estimated 25 million patients in China. The prevalence of VHD increased with age and was higher in participants with hypertension or chronic kidney disease than in their counterparts. Among participants with VHD, 55.1% were rheumatic and 21.3% were degenerative. The proportion of rheumatic decreased with age, and the proportion of degenerative rose with age. However, the prevalence of rheumatic disease was still higher in the elderly population than in the younger population. Logistic regression revealed that age and hypertension were correlated with VHD.ConclusionsIn China, rheumatic heart disease was still the major cause of the VHD, with a significant increase in degenerative heart disease. Age and hypertension are important and easily identifiable markers of VHD.
Highlights
Valvular heart disease (VHD) is mainly caused by rheumatic heart disease (RHD) or occurs as a consequence of aging worldwide
RHD remains a major problem in developing countries [1], but most valvular heart disease (VHD) in industrialized countries are degenerative [2, 3]
The weighted prevalence of VHD was 3.8% out of an estimated 25,621,503 patients in China according to the 2010 census data
Summary
Valvular heart disease (VHD) is mainly caused by rheumatic heart disease (RHD) or occurs as a consequence of aging (degenerative) worldwide. The epidemiology of VHD has changed markedly over the last 50 years worldwide. After great improvements in the Chinese economy and people’s living conditions since the policy of reformation and opening in 1978, infectious diseases, as well as RHD, have declined significantly, while chronic diseases have increased at the same time [4]. It is speculated that valvular degeneration is increasing with the accelerated demographic aging tendency in China [5]. The current status of degenerative heart disease (DHD) is uncertain. The epidemiology of valvular heart disease (VHD) has changed markedly over the last 50 years worldwide, and the prevalence and features of VHD in China are unknown.
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