A National Strategy to Detect and Treat Heart Valve Diseases in Canada

With the aging of the population in western countries, the prevalence of HVD is dramatically increasing and is a clear example of a hidden epidemic within cardiovascular disease. HVD results in substantial morbidity and mortality and places a significant burden on already scarce health care resources. However, outcomes following HVD diagnosis could improve if diagnosed early. The global burden of HVD, which has historically focused on rheumatic heart disease, has also transitioned to a greater focus on degenerative heart valve diseases. 1 Nkomo V.T. Gardin J.M. Skelton T.N. Gottdiener J.S. Scott C.G. Enriquez-Sarano M. Burden of valvular heart diseases: a population-based study. The Lancet. 2006; 368: 1005-1011 Abstract Full Text Full Text PDF PubMed Scopus (3123) Google Scholar Nevertheless, with the increase in the immigration rate because of sociopolitical conflicts and environmental crisis, we might observe a rise in the rate of rheumatic disease in developed countries. An international report, originally published in 2017 and updated this year, demonstrated that in 195 countries (including Canada) the global burden of degenerative HVD was increasing. This was driven by both population growth and aging populations globally. In 2017, there were an estimated 29.7 million cases of degenerative HVD and 145 000 deaths attributable to degenerative HVD, with 12.6 millions of these cases and 103 000 of these deaths more specifically attributable to aortic valve stenosis. 2 Roth G.A. Mensah G.A. Johnson C.O. et al. Global burden of cardiovascular diseases and risk factors. Update from the GBD 2019 study. J Am Coll Cardiol. 2020; : 2982-3021 Crossref Scopus (1848) Google Scholar Critically, the regular assessment of the burden of degenerative HVD as part of the global burden of disease will allow countries to benchmark progress in the prevention and treatment of these diseases. Contrasting with its societal and economic burden, HVD has been relatively overlooked compared to other conditions. There is a lack of awareness in the general population and public campaigns related to HVD are rare compared to many other medical conditions. In a survey of close to 9000 individuals 65 years or older, only 2% considered HVD as an important health issue. 2 Roth G.A. Mensah G.A. Johnson C.O. et al. Global burden of cardiovascular diseases and risk factors. Update from the GBD 2019 study. J Am Coll Cardiol. 2020; : 2982-3021 Crossref Scopus (1848) Google Scholar