Valvular heart disease (VHD) is present in 4.7 million people in the U.S. and this number jumps up to 10.6 million when including people who have mild to moderate VHD, a new study shows. Additionally, most of these individuals are unaware of their condition. The older the person, the more likely they are to develop VHD. Black patients had lower rates of VHD compared with White patients, but these differences only explain about half of the undertreatment rates observed across the U.S. David J. Cohen, MD, MSc, Director of Clinical and Outcomes Research at the Cardiovascular Research Foundation (CRF), New York, and Director of Academic Affairs at the St. Francis Hospital and Heart Center, Roslyn, New York, presented these results during a late-breaking clinical trial session on Monday at the Transcatheter Cardiovascular Therapeutics (TCT) 2025 conference in San Francisco. Cardiovascular disease is becoming more prevalent in the aging population around the world. Many patients with VHD go untreated or are unaware of their valvular disease. Understanding the prevalence of VHD is critical for developing early treatment strategies for this population. Investigators in this study examined the prevalence of VHD in older people in the U.S.; analyzed the impacts of age, sex, race and ethnicity on VHD prevalence; and predicted future rates of VHD across demographics. Individuals were included if they were between the ages of 65 and 85 years and willing to provide their basic demographic information. People were excluded only if they had a history of complex congenital heart disease. No specific study sites were used in this trial, the investigators used CVS and Walgreens pharmacies to gather data from a random sample. Study visits were performed in the participants’ homes. A core laboratory from the CRF interpreted the echocardiograms. Prevalence of moderate or greater VHD and individual components of VHD, including aortic stenosis (AS), aortic regurgitation (AR), mitral stenosis (MS), mitral regurgitation (MR) and tricuspid regurgitation (TR), was the primary endpoint in this study. Secondary endpoints included clinically significant VHD with advanced classifications. Participants were categorized by age, sex, race and ethnicity. A total of 3,000 patients (57.1% female; 82.1% White, 14.8% Black, 9.4% Hispanic) completed the study visit and procedures. Participant data came from all across the U.S., from the Northeast (16.1%), South (43.3%), Midwest (18.3%) and West (22.0%). Across all age groups, VHD was present in 8.2% of the participants (95% confidence interval [CI]=7.0-9.5). Both men and women were more likely to have VHD as they aged, but this increase was 5-fold in men and 2.5-fold in women. Notably, men were much more likely than women to develop TR as they aged over 75 years. The absolute prevalence of VHD is higher than women across all age groups, but this gap narrows in patients aged 80-85 years. “We estimate that there are at least 4.7 million older individuals living with moderate or severe VHD, of which 1.3 million have severe disease,” said Dr. Cohen in during a TCT press conference Monday morning. Analysis of the secondary endpoints revealed 18.4% of the 65-85-year-old population have clinically significant VHD. Secondary analysis also showed, after adjusting for age and sex, Black patients had a 21% lower prevalence of VHD compared with White patients, seen mostly in rates of AS and AR. Investigators predicted that these numbers will increase from 4.5 million people with VHD to 6 million people with VHD in the next 35 years. They also noted key limitations, including that patients over 85 were excluded and patients with known, symptomatic valve disease are likely underrepresented. Overall, this study demonstrated the prevalence and growing rates of VHD in older U.S. adults, which are predicted to grow significantly in the next 35 years. “Perhaps most importantly, the PREVUE Valve study demonstrates the power of novel approaches to recruit and enroll participants who are broadly representative of the US population,” Dr. Cohen concluded during the press conference. This study was sponsored by the Cardiovascular Research Foundation. Investigator-initiated grants from Edwards Lifesciences, Abbott and Philips also funded the study. Image Caption: David J. Cohen, MD, MSc, presents during a press conference Monday, October 27, at the Transcatheter Cardiovascular Therapeutics (TCT) 2025 conference in San Francisco. Image Credit: Screenshot by Bailey G. Salimes, CRTonline.org.