Key result
Global nonrheumatic valvular heart disease incidence rose to ~25 per 100,000 despite declining mortality.
Why the study?
Nonrheumatic valvular heart disease is an increasing public health concern, prompting assessment of its burden and quality of care in Asia and globally.
Observational
Effect estimate: AAPC 0.149 (95% CI 0.095-0.203)
Absolute Event Rate: 25% vs 23.9%
The absolute burden of nonrheumatic valvular heart disease is rising globally and in aging Asian populations despite historical improvements in quality of care and declining age-standardized mortality rates.
Rising incidence despite falling mortality may expand future clinical burden; leaves open drivers and prevention targets in aging populations.
BACKGROUND: Nonrheumatic valvular heart disease is an increasing public health concern. This study assessed the burden and quality of care for nonrheumatic valvular heart disease in Asia and at the global level from 1990 to 2021, and projected trends to 2050 using data from the GBS (Global Burden of Disease Study) 2021. METHODS: Incidence, age-standardized incidence rate, deaths, age-standardized mortality rate, disability-adjusted life years, and age-standardized disability-adjusted life years rate were analyzed. A time-series model (autoregressive integrated moving average was used for forecasting future trends. A quality-of-care index was constructed through principal component analysis, and future quality-of-care index trends were projected using a Bayesian age-period-cohort model. RESULTS: From 1990 to 2021, both incident nonrheumatic valvular heart disease cases and age-standardized incidence rate increased globally and in Asia, whereas age-standardized mortality rate and age-standardized disability-adjusted life years rate declined. Projections suggest that incident cases will continue to rise through 2050, with age-standardized incidence rate decreasing globally but remaining relatively stable in Asia. Although Asia has lower age-standardized rates than the global average, its projected age-standardized incidence rate increase is greater. Disease burden varied by age and sex, with incidence peaking at 70 to 74 years. Mortality exceeded that of men among women after age 70 to 74. Nonrheumatic aortic valve disease contributed to the greatest burden. Quality-of-care index improved markedly from 1990 to 2021 globally and in Asia, but recent gains have slowed, suggesting a plateau in care improvement. CONCLUSIONS: Nonrheumatic valvular heart disease burden is rising, especially in aging Asian populations. Despite declining mortality and improved care quality, increasing incidence and slowing quality-of-care index gains may intensify future health system pressures.
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Niu et al. (2026) conducted an observational in Nonrheumatic valvular heart disease. Time and demographic trends (1990-2021) vs. Baseline (1990) was evaluated on Global age-standardized incidence rate (ASIR) per 100,000 (AAPC 0.149, 95% CI 0.095-0.203). From 1990 to 2021, the global age-standardized incidence rate of nonrheumatic valvular heart disease increased from 23.90 to 25.00 per 100,000 (AAPC 0.149), despite declining mortality rates.
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