Deaths from heart valve disease rising among U.S. adults ages 65 and older
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After nearly two decades of decline, valvular heart disease death rates have increased from 2018 to 2023 and are predicted to remain elevated through 2040, according to independent, new preliminary research presented at the American Heart Association's Scientific Sessions 2026, held Nov. 6–9 in Chicago.
Heart valve disease is an umbrella term for conditions that arise when any of the heart's four valves—aortic, mitral, pulmonary or tricuspid—stop working properly. According to the American Heart Association's 2026 Heart Disease and Stroke Statistics, more than 80 million people worldwide live with heart valve disease and the number is growing. In the U.S., heart valve disease contributes to more than 57,000 deaths each year.
"Heart valve disease is an increasingly important health concern as the U.S. population ages, but information has been limited on just how much specific populations are currently impacted and what trends are expected for the future," said study author Hritvik Jain, M.D., a resident physician in internal medicine at Allegheny General Hospital in Pittsburgh.
"Our study found that the decades-long decline in deaths from heart valve disease has stopped. As the U.S. population continues to age, we need to focus on earlier detection, timely treatment and equitable access to specialized valve care, particularly for the oldest adults and those living in rural communities."
To learn more about the potential impact on the aging population, researchers analyzed death information from the U.S. Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research (WONDER) resource, from 1999 to 2023, focused on U.S. adults ages 65 and older. They evaluated death rate trends, examined generational and age-related patterns and used statistical software to forecast death rates through 2040.
Key findings:
- There were more than 1.2 million heart valve disease-related deaths from 1999 to 2023.
- The death rate declined from a high of 123.2 deaths per 100,000 in 1999 to its lowest levels immediately before the pandemic period, after which rates increased and reached 109.2 deaths per 100,000 in 2023.
- Men had higher rates of valvular heart disease death than women (124.7 vs. 103.1/100,000), while non-Hispanic white adults had the highest valvular heart disease death rates (122.4/100,000) among all racial/ethnic groups included in the analysis.
- Nonmetropolitan areas also had higher death rates than metropolitan areas (120.5 versus 110.1/100,000).
- Adults ages 85 and older had more than 15 times the death rate from valvular heart disease in comparison to adults ages 65 to 69 in 1999 (when death rates from heart valve disease were highest).
- Researchers projected that death rates from heart valve disease would remain around 109.2/100,000 through 2040, rather than continuing the previous decline.
"We also found that while death rates improved for newer generations in their late 60s, those gains did not continue into very old age. At age 85 and older, newer generations had higher death rates than earlier generations at the same age," Jain said.
In 2020, the American Heart Association launched Target: Aortic Stenosis (Target: AS) to help improve outcomes for people living with the disease. The program supports earlier and more accurate diagnosis, timely treatment and ongoing disease management. It provides hospital care teams with tools and resources to deliver consistent, evidence-based care for patients with aortic stenosis.
In addition, in 2025, the association launched the Heart Valve Initiative, a national effort to ensure individuals with heart valve disease are identified earlier, treated sooner and supported throughout their care journey.
"The recent reversal of progress in valvular heart disease mortality is especially alarming in light of the substantial advances in treatment achieved over the past decade and a half," said Sreekanth Vemulapalli, M.D., a volunteer member of the American Heart Association's Target: Aortic Stenosis Scientific Advisory Group, an associate professor of medicine at Duke University, a core faculty member at the Duke-Margolis Institute for Health Policy and a member of the Duke Clinical Research Institute.
"This disconnect between therapeutic innovation and population-level outcomes highlights the critical need for the American Heart Association's quality improvement and educational initiatives to improve awareness, care delivery and patient outcomes."
Study details, background, design and limitations:
- The study population included 1,204,490 valvular heart disease-related deaths among U.S. adults 65 years of age and older from 1999–2023; 42.9% were men and 57.1% were women. The study population included people whose death records listed valvular heart disease, including rheumatic and nonrheumatic valvular disorders. Nonrheumatic aortic valve disease accounted for the majority of the deaths.
- The study analyzed U.S. national mortality data covering 1999–2023, from the U.S. Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (WONDER) Multiple Cause of Death database. VHD-related deaths were identified using ICD-10 codes listed as either the underlying or contributing cause of death.
- Age-adjusted death rates were calculated using the 2000 U.S. Standard Population. Joinpoint regression software was used to assess temporal trends. In addition, age-period-cohort analysis evaluated age, calendar-period and birth-cohort effects, and ARIMA models projected mortality through 2040.
- Study limitations include that, because the cause of death was sourced from death certificate data, it may be subject to coding inaccuracies and cannot capture disease severity, echocardiographic findings or individual treatment history. In addition, the study cannot establish causality, and the COVID-19 pandemic may have influenced trends during the final years of the study.
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CardiologyHealthy agingCommon illnesses & Prevention Provided by American Heart Association Who's behind this story?
Sadie Harley
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