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A nationwide contemporary epidemiological portrait of valvular heart diseases
  1. Marie Annick Clavel1,
  2. Bernard Iung2,
  3. Philippe Pibarot1
  1. 1Institut Universitaire de Cardiologie et de Pneumologie, Québec Heart & Lung Institute, Université Laval, Québec, Canada
  2. 2Department of Cardiology, Bichat Hospital, AP-HP, DHU FIRE, Paris-Diderot University, Paris, France
  1. Correspondence to Dr Philippe Pibarot, Institut Universitaire de Cardiologie et de Pneumologie, Québec Heart & Lung Institute, Québec, G1V-4G5, Canada; philippe.pibarot{at}

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The spectrum of valvular heart diseases (VHDs) has evolved during the past decades in the developed countries. However, there are few epidemiological data on VHD and large contemporary population-based studies are lacking. In this issue of the journal, Andell et al present the findings of a nationwide study in Sweden that includes a population of about 10 million people.1 The authors used nationwide registers to identify all patients with first diagnosis of VHD at Swedish hospitals between 2003 and 2010. The cases diagnosed in the years 2000, 2001 and 2002 were excluded, therefore allowing to estimate the incidence rates of VHDs. The incidence of each VHD was then stratified for age and sex.

Andell et al should be commended for this elegant and important study that provides a contemporary and comprehensive portrait of the epidemiology spectrum of VHD within a large European country.1 Previous epidemiology studies on VHD included either representative samples2 or primary care series recruited locally3 and the majority of these studies reported only prevalence rates. Incidence rates have been previously reported for aortic stenosis (AS)4 5 but the present study is the first to report incidence rates for the different VHDs.

A contemporary portrait of the epidemiology of VHD in Sweden

Over the 8-year period of the present study conducted in the Swedish population, a new diagnosis of VHD was identified in close to 77 000 persons.1 The overall incidence of VHD was 63.9 per 100 000 person-years and the most common disease was AS (47%) , followed by mitral regurgitation (MR) (24%) and aortic regurgitation (AR) (18%) (figure 1). In the vast majority (68.9%) of the cases, the VHDs were diagnosed in subjects aged ≥65 years, except for pulmonary valve disease whose incidence peaked in newborns. Half of the persons with AS also had atherosclerotic vascular disease, which provides further support to the commonality …

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