Large-scale community echocardiographic screening reveals a major burden of undiagnosed valvular heart disease in older people: the OxVALVE Population Cohort Study
Open accessAbstract
BACKGROUND: Valvular heart disease (VHD) is expected to become more common as the population ages. However, current estimates of its natural history and prevalence are based on historical studies with potential sources of bias. We conducted a cross-sectional analysis of the clinical and epidemiological characteristics of VHD identified at recruitment of a large cohort of older people. METHODS AND RESULTS: We enrolled 2500 individuals aged ≥65 years from a primary care population and screened for undiagnosed VHD using transthoracic echocardiography. Newly identified (predominantly mild) VHD was detected in 51% of participants. The most common abnormalities were aortic sclerosis (34%), mitral regurgitation (22%), and aortic regurgitation (15%). Aortic stenosis was present in 1.3%. The likelihood of undiagnosed VHD was two-fold higher in the two most deprived socioeconomic quintiles than in the most affluent quintile, and three-fold higher in individuals with atrial fibrillation. Clinically significant (moderate or severe) undiagnosed VHD was identified in 6.4%. In addition, 4.9% of the cohort had pre-existing VHD (a total prevalence of 11.3%). Projecting these findings using population data, we estimate that the prevalence of clinically significant VHD will double before 2050. CONCLUSIONS: Previously undetected VHD affects 1 in 2 of the elderly population and is more common in lower socioeconomic classes. These unique data demonstrate the contemporary clinical and epidemiological characteristics of VHD in a large population-based cohort of older people and confirm the scale of the emerging epidemic of VHD, with widespread implications for clinicians and healthcare resources.
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A study of 2,500 people aged 65 years or older found 4.9% previously diagnosed with clinically significant VHD and another 6.4% with undiagnosed VHD, more than doubling overall prevalence.
“A study of 2,500 people 65 years of age or older found that 4.9% were previously diagnosed with clinically significant (graded moderate or severe) VHD and found another 6.4% with undiagnosed VHD more than doubling the overall prevalence14.”
From Detecting structural heart disease from electrocardiograms using AI (2025) · cites this paper as [14]
The Abstract reports 2,500 participants aged ≥65, 6.4% with undiagnosed moderate or severe VHD, and 4.9% with pre-existing VHD, yielding 11.3% overall—more than twice 4.9%. However, the Discussion says the previously diagnosed group was excluded from screening and its clinical significance was assumed, not confirmed by moderate-or-severe grading. Page numbers are not available in the supplied copy. (LLM, conf=0.87)
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- Authors
- d'Arcy, J. L., Coffey, S., Loudon, M. A., Kennedy, A., Pearson-Stuttard, J., Birks, J., Frangou, E., Farmer, A. J., Mant, D., Wilson, J., Myerson, S. G., & Prendergast, B. D.
- Affiliations
- NIHR Oxford Biomedical Research Centre (GB)
- University of Oxford (GB)
- Corresponding author
- Prendergast, Bernard D.
- ORCID
- Venue
- European Heart Journal
- Publisher
- Oxford University Press (OUP)
- Published
- 2016-06-26
- Volume
- 37
- Issue
- 47
- Pages
- 3515-3522
- ISSN
- 0195-668X (ISSN-L)
- 1522-9645
- PMC
- PMC5216199
- OpenAlex
- W2470498562
- Cited by
- 724
- References
- 3
- Citations by year
- 2026: 82 · 2025: 130 · 2024: 106 · 2023: 83 · 2022: 82 · 2021: 72 · 2020: 49 · 2019: 54 · 2018: 31 · 2017: 28 · 2016: 6 · 2015: 1
- FWCI
- 32.67
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Heart Journal (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- National Institute of Health Research (NIHR) Thames Valley Comprehensive Local Research Network (UKCRN ID 6086)
- NIHR Oxford Biomedical Research Centre
- NIHR School for Primary Care Research
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
- Keywords
- valvular heart disease, older adults, aortic valve sclerosis, mitral regurgitation, aortic regurgitation, aortic stenosis, socioeconomic deprivation, atrial fibrillation, prevalence, transthoracic echocardiography, primary care screening
- MeSH terms
- Aged, Cross-Sectional Studies, Echocardiography, Heart Valve Diseases, Humans, Cohort Studies
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