Paving the way for the prevention of valvular diseases
-
By
-
Louis-Marie Desroche
-
Victor Aboyans
-
November 27, 2025
-
0 min
Advancing Strategies for the Prevention of Valvular Heart Disease
Overview
Recent research highlights the long preclinical phase of degenerative valvular heart disease (VHD) and identifies modifiable cardiovascular risk factors that can inform personalized prevention strategies. Large cohort studies have developed risk prediction tools and linked lifestyle, metabolic, and biological markers to disease progression, enabling earlier intervention and tailored monitoring.
Background
Valvular heart disease, particularly degenerative forms such as aortic stenosis (AS), develops over many years with measurable preclinical changes like valve calcification. Traditional cardiovascular risk factors including hypertension, diabetes, and hyperlipidemia contribute significantly to disease onset and progression. Understanding these associations allows for the development of risk prediction models and preventive strategies. Recent studies emphasize sex differences in risk profiles and the potential role of biomarkers and lifestyle factors in guiding clinical management.
Data Highlights
| Study | Population | Key Findings |
|---|---|---|
| Copenhagen General Population Study (Kjeldsen et al.) | ~94,000 participants | 10-year absolute risk of AS up to ~19% based on age, sex, BMI, BP, diabetes, lipoprotein(a) |
| SCAPIS Imaging Cohort (Wang et al.) | 29,221 middle-aged adults (50-64 years) | 7% prevalence of aortic valve calcification; 34.5% population-attributable risk from six modifiable factors |
| UK Biobank (Yang et al.) | 436,184 participants | Hypertension largest risk factor; sex-specific risk patterns for AS, AR, MR |
| Kailuan Cohort (Gui et al.) | 30,561 participants | Higher Life’s Essential 8 score linked to 34-63% lower odds of AVC |
| UK Biobank Proteomics (Xiang et al.) | UK Biobank participants | Proteomic signature explains ~36% of association between Life’s Crucial 9 and AS risk |
| Copenhagen General Population Study (Kaltoft et al.) | General population | Diabetes associated with increased odds of aortic (OR 1.67) and mitral valve calcification (OR 1.89) |
| UK Biobank (Chen et al.) | Longitudinal data ~14 years | Prediabetes (HR 1.21) and diabetes (HR 1.66) predict incident AS independent of genetic risk |
| UK Biobank (Wei et al.) | Prospective study | Artificially sweetened beverages >1/day linked to higher AS, AR, MR risk (HRs 1.35-1.42) |
| Italian cohort (Myasoedova et al.) | >2,500 patients with MI | Aortic valve sclerosis predicts 3.8-fold higher risk of recurrent MI |
| Danish cohort (Hadziselimovic et al.) | Asymptomatic non-severe AS patients | ASGARD risk score identifies low-risk patients with ≤5% event rate over 15 months (AUC ~0.74) |
Key Findings
- Degenerative valve disease has a prolonged preclinical phase detectable by imaging and risk factors.
- Modifiable cardiovascular risk factors such as hypertension, diabetes, hyperlipidemia, smoking, and obesity significantly contribute to valve calcification and stenosis.
- Sex differences exist in risk factor impact, suggesting tailored prevention strategies are needed.
- Composite cardiovascular health scores (e.g., Life’s Essential 8 and Life’s Crucial 9) correlate with lower valve calcification and AS risk, mediated partly by proteomic inflammatory pathways.
- Glycemic control is important even before overt diabetes to reduce valve disease risk, independent of genetic predisposition.
- Novel risk tools like 10-year AS risk charts and the ASGARD score enable personalized risk stratification and smarter clinical monitoring.
Clinical Implications
Clinicians should incorporate validated risk prediction tools into routine practice to identify individuals at elevated risk for valvular heart disease early. Emphasis on controlling modifiable factors such as hypertension, diabetes, and lifestyle behaviors can delay or prevent progression. Sex-specific risk profiles and biomarker assessments may further refine prevention and monitoring strategies, optimizing resource allocation and patient outcomes.
Conclusion
Emerging evidence supports a paradigm shift toward proactive, personalized prevention of valvular heart disease by leveraging risk stratification, modifiable factor control, and biomarker integration. These advances promise to transform clinical management from reactive intervention to early, targeted prevention.
References
- Kjeldsen et al. 2024 -- Cardiovascular risk factors and aortic valve stenosis: towards 10 year absolute risk charts for primary prevention
- Wang et al. 2024 -- Prevalence and common cardiovascular risk factors in aortic valve calcification in the middle-aged general population
- Yang et al. 2024 -- Sex differences in cardiovascular–kidney–metabolic risk factors associated with degenerative valvular heart disease
- Gui et al. 2024 -- High Life’s Essential 8 score is associated with lower aortic valve calcification
- Xiang et al. 2024 -- Aortic stenosis risk and Life’s Crucial 9: the role of proteomics and inflammation
- Kaltoft et al. 2024 -- Diabetes and elevated plasma glucose in heart valve calcification and disease: the Copenhagen General Population Study
- Chen et al. 2024 -- Hyperglycaemia and genetic susceptibility in relation to incident degenerative aortic valve stenosis
- Wei et al. 2024 -- Associations between sweetened beverage consumption, degenerative valvular heart disease, and related events: a prospective study from UK Biobank
- Myasoedova et al. 2024 -- Non-stenotic fibro-calcific aortic valve as a predictor of myocardial infarction recurrence
- Hadziselimovic et al. 2024 -- Development and validation of the ASGARD risk score for safe monitoring in asymptomatic non-severe aortic valve stenosis
This content is an AI-generated, fully rewritten summary based on a published scholarly article. It does not reproduce the original text and is not a substitute for the original publication. Readers are encouraged to consult the source for full context, data, and methodology.
