Changing causes of heart valve disease mortality in New Zealand from 1988 to 2007.

AIM: We wished to determine the mortality burden of valvular heart disease (VHD) in New Zealand, and how it changed prior to the introduction of transcatheter aortic valve replacement.

METHOD: Patient-level cause of death data from 1988 to 2007 were used to examine trends in VHD mortality rates over time. Our outcome measure was death, where the primary cause of death was valvular heart disease.

RESULTS

The annual number of VHD deaths increased 2.9% in New Zealand each year (p<0.001). The total VHD mortality rate increased with older age and male sex. There was little, if any, overall change in age- and sex-adjusted total VHD mortality rate over time (annual mortality rate ratio 0.998, p=0.21). The oldest age group, aged 85 years and above, which now contribute most to total VHD mortality, had an increase in mortality rate through the 1990s, which plateaued after the year 2000. The adjusted mortality rate for non-rheumatic aortic valve disease increased (p<0.001), while that for rheumatic heart disease and endocarditis decreased (p<0.001). Assuming VHD mortality rates remain stable, deaths due to VHD are projected to double over the next 25 years.

CONCLUSION

Adjusted VHD mortality rates showed no change over the two decades examined. Without a substantial reduction in mortality rates, the ageing population is likely to lead to an increase in VHD deaths in the future.