In 2021, 1.38 million adults aged ≥60 had heart failure due to non-rheumatic calcific aortic valve disease, rising 123% since 1990 despite a 16.7% drop in age-standardized prevalence.
What is the global burden, trend, and causal relationship of non-rheumatic calcific aortic valve disease contributing to heart failure in older adults?
Heart failure driven by non-rheumatic calcific aortic valve disease is a rapidly growing global burden, particularly in aging populations and lower-SDI regions, with cases projected to increase 79% by 2040.
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BACKGROUND: Global aging and lifestyle shifts raise cardiovascular disease burden, but the specific contribution of non-rheumatic calcific aortic valve disease (nrCAVD) to heart failure (HF) in older adults is incompletely defined. OBJECTIVES: To quantify global trends, drivers, inequalities, and future projections of HF attributable to nrCAVD among persons aged ≥60 and to assess causality. METHODS: Using GBD 2021 estimates (1990-2021) for prevalence, Years Lived with Disability(YLDs), and age-standardized rates across 204 countries, we applied decomposition analysis, Social Inequality Index (SII), and Bayesian age-period-cohort forecasting to 2040. Two-sample Mendelian randomization (FinnGen GWAS) evaluated causality. RESULTS: In 2021 an estimated 1.38 million persons aged ≥60 had HF due to nrCAVD with 123,907 YLDs-cases rose 123 % since 1990 though age-standardized prevalence fell ∼16.7 %. Male burden was ∼1.5 × female. High-SDI regions had the highest rates but burdens are rising in middle/low-SDI areas. Decomposition attributed increases to population growth (+100.9 %) and aging (+20.0 %), partially offset by epidemiological improvement (-20.9 %). Cross-country inequality declined. Forecasts project ∼79 % increases in cases and YLDs by 2040. Mendelian randomization supported a causal effect of nrCAVD on HF. CONCLUSIONS: These findings demonstrate that heart failure due to non-rheumatic calcific aortic valve disease represents a growing global health burden in aging populations, particularly in lower-SDI settings. Targeted preventive measures, early screening, and equitable access to effective interventions are urgently needed to mitigate this trend.
Zhu et al. (Wed,) reported a other. In 2021, 1.38 million adults aged ≥60 had heart failure due to non-rheumatic calcific aortic valve disease, rising 123% since 1990 despite a 16.7% drop in age-standardized prevalence.