After nearly two decades of steady decline, death rates from valvular heart disease among U.S. adults ages 65 and older reversed course between 2018 and 2023, rising from 104 to more than 109 deaths per 100,000 people. The preliminary findings, presented at the American Heart Association’s Scientific Sessions 2026, project that these rates will remain around 109 per 100,000 through 2040 rather than resuming the previous decline. The reversal carries significant implications for public health, clinical practice, and health equity as the U.S. population ages.
Heart valve disease encompasses conditions that impair the function of the heart’s four valves—aortic, mitral, pulmonary, and tricuspid. According to the American Heart Association’s 2026 Heart Disease and Stroke Statistics, more than 80 million people worldwide live with the condition, and in the U.S. it contributes to more than 57,000 deaths annually. The new study analyzed data from the Centers for Disease Control and Prevention’s WONDER database, covering more than 1.2 million heart valve disease-related deaths from 1999 to 2023 among adults 65 and older. Researchers used Joinpoint regression software and age-period-cohort analysis to identify trends and forecast mortality through 2040.
The study found stark disparities: men had higher death rates than women (124.7 vs. 103.1 per 100,000), non-Hispanic white adults had the highest rates among racial and ethnic groups (122.4 per 100,000), and nonmetropolitan areas had higher rates than metropolitan areas (120.5 vs. 110.1 per 100,000). Adults 85 and older had more than 15 times the death rate of those 65 to 69 in 1999. “We also found that while death rates improved for newer generations in their late 60s, those gains did not continue into very old age,” said study author Hritvik Jain, M.D., a resident physician at Allegheny General Hospital in Pittsburgh. “At age 85 and older, newer generations had higher death rates than earlier generations at the same age.”
The implications are particularly concerning given the advances in treatment over the past 15 years. “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 and associate professor of medicine at Duke University. “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.”
The Association has launched programs to address these gaps. In 2020, it introduced Target: Aortic Stenosis™ to support earlier and more accurate diagnosis and timely treatment. In 2025, it launched the Heart Valve Initiative, a national effort to ensure individuals with heart valve disease are identified earlier and supported throughout their care journey. The findings also underscore the need for equitable access to specialized valve care, particularly for the oldest adults and rural communities. The full abstract is available online, and additional details can be found in the release link. As the population ages, the projected plateau in mortality signals a pressing need for sustained public health interventions and research, which the Association supports through initiatives such as the recently announced Scientific researchers awarded $15 million to study heart valve disease.
