The PREVUE-VALVE study was designed to determine the true prevalence and demographic determinants of valvular heart disease in US elderly population using a decentralized, representative approach.
A total of 3000 individuals aged 65 to 85, with no complex congenital heart disease, were randomly recruited via electronic invitations and postal mail. Assessment studies (comprehensive 2D echocardiogram and ECG) were conducted at each participant’s home.
The primary endpoint was prevalence of moderate or greater valvular disease, including aortic, mitral, and tricuspid stenosis or regurgitation. The secondary endpoint expanded this definition to clinically significant disease by including mild-moderate lesions of prognostic relevance.
Results showed an 8.2 % overall prevalence of ≥moderate valvular disease (95% CI 7.0–9.5), equivalent to approximately 4.7 million US elders with this condition.
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Tricuspid regurgitation resulted the most frequent lesion, followed by aortic stenosis. Prevalence significantly rose with age and was higher in men, though 59 % of affected individuals were women. When including mild-moderate lesions, clinically significant disease prevalence rose to 18.4 % (95% CI 16.7–20.2), equivalent to 10.6 million people (63 % women). After adjusting for age and sex, aortic valve disease resulted less common among African Americans vs Caucasian (p < 0.05), with no difference for Hispanic.
Based on national demographic projections, prevalence is expected to increase by 4 million additional cases by 2060, driven largely by a 74 % rise in the 80–85 age group.
In conclusion, the PREVUE-VALVE has shown that moderate or greater valvular disease affects one in twelve US older adults, and nearly one in five has clinically significant valvular disease. The high prevalence in women and the steep increase with age highlight the need for structured screening and early-access programs for the timely management of this population.
Presented by David J. Cohen, MD, MSc et al. at TCT 2025 (Late-Breaking Clinical Trials), October 27, San Francisco, USA.
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