Death rates from valvular heart disease among U.S. adults ages 65 and older have reversed a nearly two-decade decline, rising from 104 to more than 109 deaths per 100,000 people between 2018 and 2023, according to preliminary research presented at the American Heart Association’s Scientific Sessions 2026 in Chicago.
The study, which analyzed death data from 1999 to 2023, found that after reaching a low just before the pandemic, death rates climbed and are projected to remain around 109.2 per 100,000 through 2040. That projection signals a break from the long-term decline observed for decades, researchers said.
“The decades-long decline in deaths from heart valve disease has stopped,” said study author Hritvik Jain, M.D., a resident physician in internal medicine at Allegheny General Hospital in Pittsburgh. “As the U.S. population continues to age, we need to focus on earlier detection, timely treatment and equitable access to specialized valve care, particularly for the oldest adults and those living in rural communities.”
The findings carry significant implications for an aging U.S. population. According to the American Heart Association’s 2026 Heart Disease and Stroke Statistics, more than 80 million people worldwide live with heart valve disease, and in the U.S. the condition contributes to more than 57,000 deaths each year. The new analysis of more than 1.2 million deaths from 1999 to 2023 shows the burden is not evenly distributed: 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 adults 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,” Jain said. “At age 85 and older, newer generations had higher death rates than earlier generations at the same age.”
The study used Joinpoint regression software to assess trends and ARIMA models to project mortality through 2040. The researchers noted limitations: death-certificate data may contain coding inaccuracies and cannot capture disease severity or treatment history, and the study cannot establish causality. The COVID-19 pandemic may also have influenced trends in the final years.
The American Heart Association has launched initiatives aimed at improving outcomes. In 2020, it introduced Target: Aortic Stenosis™ to support earlier diagnosis and timely treatment, and in 2025 it launched the Heart Valve Initiative, a national effort to ensure individuals with heart valve disease are identified earlier and treated sooner.
“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 an 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.”
As the U.S. population continues to age, the projected plateau in death rates suggests that without broader access to earlier detection and specialized care, the gains of recent decades may not be sustained. The findings are considered preliminary until published in a peer-reviewed journal.
