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Valve Disease Study Suggests New Public Health Concern

, from 0.7 percent in 18- to 44-year-olds to 13.3 percent in those 75 and older. The projected national estimate of valve diseases based on the age and gender distribution of the 2000 U.S. population census is 2.5 percent of adults or approximately 5 million people.

In Olmsted County, 1.8 percent (adjusted to U.S. census figures) of the adults were diagnosed with valve disease and prevalence also increased with age, from 0.3 percent in the 18- to 44-year-olds to 11.7 percent of those 75 and older. Remarkably, the prevalence of valve disease was similar in the population but in the community, valve disease was diagnosed less in women, suggesting a possible gender bias and the need for further study, Dr. Nkomo says.

“The results of this study are not trivial. We predict -- in view of the growth and aging of the population -- that the number of U.S. patients with valve disease will double in the next 20 years,” says co-author Maurice Enriquez-Sarano, M.D., also a Mayo Clinic cardiologist.

An echocardiogram -- a noninvasive test that uses sound waves to create a moving picture of the heart -- is done to evaluate murmurs or causes of shortness of breath or chest pain or heart failure, and is ideal for detecting or confirming valve diseases, Dr. Nkomo says.

Valve diseases are referred to as silent killers in part because a person can have severe valve disease without having symptoms, and it may take some time before there is heart failure. “When physicians diagnose valve disease in the elderly, we hesitate to perform surgery because of the risks involved,” Dr. Nkomo says.

But research shows that cardiac surgery for valve disease has now much improved results, particularly in the elderly, says Dr. Enriquez-Sarano, pointing to Mayo Clinic research published in the July 17 issue of Circulation. While elderly patients undergoing valve surgery have higher risks of operation, they benefited from the surgery as much as
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