Nkomo Vuyisile T, Gardin Julius M, Skelton Thomas N, Gottdiener John S, Scott Christopher G, Enriquez-Sarano Maurice
Mayo Clinic, Rochester, MN 55905, USA.
Lancet. 2006 Sep 16;368(9540):1005-11. doi: 10.1016/S0140-6736(06)69208-8.
Valvular heart diseases are not usually regarded as a major public-health problem. Our aim was to assess their prevalence and effect on overall survival in the general population.
We pooled population-based studies to obtain data for 11 911 randomly selected adults from the general population who had been assessed prospectively with echocardiography. We also analysed data from a community study of 16 501 adults who had been assessed by clinically indicated echocardiography.
In the general population group, moderate or severe valve disease was identified in 615 adults. There was no difference in the frequency of such diseases between men and women (p=0.90). Prevalence increased with age, from 0.7% (95% CI 0.5-1.0) in 18-44 year olds to 13.3% (11.7-15.0) in the 75 years and older group (p<0.0001). The national prevalence of valve disease, corrected for age and sex distribution from the US 2000 population, is 2.5% (2.2-2.7). In the community group, valve disease was diagnosed in 1505 (1.8% adjusted) adults and frequency increased considerably with age, from 0.3% (0.2-0.3) of the 18-44 year olds to 11.7% (11.0-12.5) of those aged 75 years and older, but was diagnosed less often in women than in men (odds ratio 0.90, 0.81-1.01; p=0.07). The adjusted mortality risk ratio associated with valve disease was 1.36 (1.15-1.62; p=0.0005) in the population and 1.75 (1.61-1.90; p<0.0001) in the community.
Moderate or severe valvular diseases are notably common in this population and increase with age. In the community, women are less often diagnosed than are men, which could indicate an important imbalance in view of the associated lower survival. Valve diseases thus represent an important public-health problem.
心脏瓣膜病通常不被视为主要的公共卫生问题。我们的目的是评估其在普通人群中的患病率及其对总体生存的影响。
我们汇总了基于人群的研究，以获取11911名从普通人群中随机选取的成年人的数据，这些人接受了前瞻性超声心动图评估。我们还分析了一项针对16501名成年人的社区研究数据，这些人接受了临床指征的超声心动图评估。
在普通人群组中，615名成年人被诊断为中度或重度瓣膜病。男女之间此类疾病的发生率没有差异（p = 0.90）。患病率随年龄增长而增加，从18 - 44岁人群中的0.7%（95%置信区间0.5 - 1.0）增至75岁及以上人群中的13.3%（11.7 - 15.0）（p < 0.0001）。根据美国2000年人口的年龄和性别分布校正后，瓣膜病的全国患病率为2.5%（2.2 - 2.7）。在社区组中，1505名（校正后为1.8%）成年人被诊断为瓣膜病，患病率随年龄显著增加，从18 - 44岁人群中的0.3%（0.2 - 0.3）增至75岁及以上人群中的11.7%（11.0 - 12.5），但女性的诊断率低于男性（优势比0.90，0.81 - 1.01；p = 0.07）。在普通人群中，与瓣膜病相关的校正后死亡风险比为1.36（1.15 - 1.62；p = 0.0005），在社区中为1.75（1.61 - 1.90；p < 0.0001）。
中度或重度瓣膜病在该人群中明显常见且随年龄增加。在社区中，女性的诊断率低于男性，鉴于其较低的生存率，这可能表明存在重要的不平衡。因此，瓣膜病是一个重要的公共卫生问题。
