Aortic regurgitation epidemiology and demographics
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The prevalence of aortic regurgitation varies with age, geographic location, and gender. aortic regurgitation is unusual before the age of 50 and then increases progressively later in life. Worldwide the most common cause of aortic regurgitation is the rheumatic heart disease, particularly in the Asia, the Middle East, and the North Africa. In the United States, senile degenerative calcific aortic valve disease and bicuspid aortic valve disease are the most common causes.
Epidemiology and Demographics
The Framingham Heart Study, a prospective epidemiological study, evaluated the prevalence and severity of aortic regurgitation and other valvular diseases by color Doppler examinations in 1,696 men and 1,893 women. The study revealed that the prevalence of aortic regurgitation (ranging in severity from trace to ≥ moderate regurgitation) is 13.0% in men and 8.5% in women.
The prevalence of aortic regurgitation increases with age. It is infrequent in young patients, and occurs in < 1% of subjects under the age of 70. However people with congenital aortic valve/root defects such as bicuspid aortic valve disease and Marfan syndrome may develop aortic regurgitation much earlier in life.
Shown below are tables depicting the prevalence of AR by age and severity in men and women according the results of the Framingham Heart Study.
|Severity of AR||Prevalence of AR by age in men|
|No AR (%)||96.7||95.4||91.1||74.3||75.6|
|Moderate or severe (%)||0||0.3||0.5||0.6||2.2|
|Severity of AR||Prevalence of AR by age in women|
|No AR (%)||98.9||96.6||92.4||86.9||73|
|Moderate or severe (%)||0||0||0.2||0.8||2.3|
aortic regurgitation is more common in men than in women. In the Framingham heart population cohort study, aortic regurgitation (more than or equal to trace severity on echocardiography) was observed in 13 percent of men and 8.5 percent of women. The higher prevalence of marfan syndrome and bicuspid aortic valve in males could explain in part the greater prevalence of aortic regurgitation in men.
The prevalence of aortic regurgitation does not show any variation by race in United States. However, internationally there is significant variation in the prevalence of predisposing conditions such as rheumatic heart disease which is more common in the Asia, the Middle East, and the North Africa.
In developed countries where rheumatic heart disease is rare, aortic regurgitation may be due to bicuspid aortic valve disease or senile degenerative calcific aortic valve disease which may present in the fourth to sixth decade. Endocarditis and aortic dissection are other causes. The prevalence of any aortic regurgitation in the Framingham study was reported to be 4.9%, with regurgitation of moderate or greater severity occurring in 0.5%.
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