Findings from the PREVUE-VALVE study presented at TCT 2025 shed light on the prevalence of valvular heart disease (VHD) and its subtypes among older Americans, as well as the influence of age, sex, race and ethnicity on VHD prevalence. Importantly, the study also provides future projections on VHD prevalence based on shifting demographics of the U.S. population.

A total of 3,000 individuals between 65-85 years of age were recruited from retail pharmacies throughout the U.S. to participate in the study. After an initial screening, participants received an at-home visit during which a 12-lead electrocardiogram and a formal echocardiogram were performed. Blood samples and standardized health status assessments were also collected. The primary endpoint was the population prevalence of moderate or greater VHD and its individual components including aortic stenosis, aortic regurgitation, mitral stenosis, mitral regurgitation or tricuspid regurgitation.

Overall, the study found that the prevalence of moderate or greater VHD was 8.2%, which increased to 18.4% when individuals with mild-moderate VHD were included. "Based on current demographics, there are currently at least 4.7 million people living with moderate VHD in the U.S., and at least 10.6 million with clinically significant VHD – many of whom are unaware of their condition," said Jonathan G. Schwartz, MD, FACC, in presenting the findings. "Based on current census data, [this number] is projected to increase by nearly 4 million by 2060, driven largely by a 74% increase among the 80-85-year-old age group."

The study also found that the prevalence of VHD increases sharply with advanced age, particularly for tricuspid regurgitation and aortic stenosis, and with a somewhat greater effect in men. However, Schwartz and colleagues noted that nearly 60% of all people with significant VHD are women. They also found that age- and sex-adjusted prevalence of any VHD is roughly 20% lower among Black vs. White individuals in the U.S., largely due to lower rates of aortic valve disease.

"Many patients with VHD remain untreated due to inadequate access to appropriate care or are treated later than recommended due to a late diagnosis," said David Cohen, MD, MSc. "These findings clearly show that the prevalence of these conditions is substantial and will continue to grow over the next several decades as the population continues to age. In addition, they have important public health implications that should inform the design of future studies to help us develop tools to more effectively screen and diagnose patients with VHD and ultimately ensure broad access to treatment."

In addition to the clinical findings, the study authors said PREVUE-VALVE itself demonstrates a novel approach for recruiting and enrolling patients who are broadly representative of the U.S. population. "Application of these concepts to future trials has the potential to greatly enhance the generalizability of their findings to the full spectrum of affected individuals," Schwartz said.

Clinical Topics: Invasive Cardiovascular Angiography and Intervention, Valvular Heart Disease, Interventions and Imaging, Interventions and Structural Heart Disease, Angiography, Nuclear Imaging

Keywords: Transcatheter Cardiovascular Therapeutics, TCT25, Angiography, Heart Valve Diseases