Trends in mortality from valvular heart disease in Europe from 2001-2015

Introduction: Deaths from cardiovascular diseases such as heart failure and coronary artery disease have been declining in developed countries over the last decade. However, mortality trends from valvular heart disease (VHD) are less well known. Hypothesis: We evaluated regional and sex-specific temporal trends in VHD mortality among European Union (EU) member nations using data from the World Health Organization (WHO) mortality database. Methods: We performed a temporal analysis of the WHO mortality database between 2001 and 2015. Mortality data for non-rheumatologic VHD were obtained using corresponding ICD-10 medical diagnosis lists. We included in our analysis all EU nations with documented high-usability data as assessed by WHO. We computed age-standardized death rates (ASDR) using the world standard population. We assessed temporal trends in VHD ASDRs between countries. We compared trends using Joinpoint regression analysis. Results: In men, the median ASDR increased to 3.73 deaths / 100,000 population (IQR 2.36 - 4.97) in 2015 from 2.56 deaths / 100,000 population (IQR 1.33 - 3.11) in 2001. In women, median ASDR increased to 3.10 deaths / 100,000 population (IQR 1.83 - 4.27) in 2015 from 2.32 deaths / 100,000 population (IQR 0.84 - 2.87). Slovenia had the highest present day (2015) ASDR for males and females (8.46 deaths/100,000 and 6.94 deaths/100,0000, respectively). The lowest ASDR in males was observed in Romania with 1.00 death/100,000, whereas the lowest ASDR for females was observed in Romania as well as Lithuania was 0.86 deaths/100,000. Conclusions: In contrast to well-documented declining mortality from other CVD conditions, we identified small but increasing mortality rates from valvular heart disease across EU member nations. We observed geographic variations in mortality rates and small but important differences by gender.