Aortic stenosis epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Claudia P. Hochberg, M.D. [2], Abdul-Rahman Arabi, M.D. [3], Keri Shafer, M.D. [4], Mohammed A. Sbeih, M.D. [5]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [6]

Overview

Aortic stenosis is a major health problem primarily affecting older adults. As North American and European populations continue to live longer, aortic stenosis has major implications on the overall personal health and economic burden. The abnormalities of aortic valve morphology and function represent the most common cardiac-valve lesion particularly in elderly. The etiology of aortic stenosis is degenerative-calcific in the majority of patients.

Prevalence

Aortic stenosis is a common problem found predominantly in middle age to older adults. Less than 1% of all live births exhibit symptoms of severe aortic stenosis. Prevalence increases with age. Approximately 2% of people over the age of 65, 3% of people over age 75, and 4% of people over age 85 have the disorder. In North America and Europe, a linear relationship exists between an aging population and an increase in aortic stenosis.

the aortic valve sclerosis (aortic valve thickening and calcification without pressure gradient) seem to affect about one fourth of adults over 65 years of age, while the aortic valve stenosis is present in 2–9% of general population over 65 years of age; an increased prevalence of both sclerosis and stenosis with aging (48% and 4% in those over 85 years) is observed. Furthermore, the number of the aortic valve procedures performed over the last 10 years is increasing if we consider the aortic valve replacement alone or combined with myocardial revascularization; mitral valve surgery seems to be constant in the same period .

In the Euro Heart Survey on Valvular Heart Disease, aortic valve stenosis was the most common valve abnormality (33,9% and 46,6% in the overall group and surgical subgroup, respectively). The etiology of aortic stenosis was degenerative-calcific in the majority of patients (81,9%), while it was rheumatic in 11.2%, congenital in 5.6% and post-endocarditis in the remaining 1,3%. Among the 512 aortic stenosis patients who underwent valve replacement, 54,3% were elderly (more than 70 years), 80% had a preserved left ventricular systolic function (left ventricular ejection fraction >60%) and 85% had symptoms of heart failure (NYHA class II-IV) .

In the Cardiovascular Health Study, the Doppler echocardiographic examination performed in 5621 subjects older than 65 year without prevalent cardiovascular disease at entry identified an aortic sclerosis (valve thickening and iperreflectivity) in 29% of overall population and an aortic stenosis (valve abnormalities and instantaneous pressure gradient >25 mmHg) in 2% .

As a disease, aortic stenosis has a high rate of morbidity and mortality resulting in a large personal and economic burden on affected populations. Without medical intervention, aortic stenosis can be a major health problem.

Incidence

The incidence of aortic stenosis is correlated to the age of the patient, primarily affecting older adults. Every year, approximately 29% of people older than 65 years and 37% of people older than 75 years become symptomatic of aortic stenosis.

Sources

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1550260/

References

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