About 300,000 in UK have potentially deadly aortic valve condition, study finds

·3 min read
<span>Photograph: Peter Byrne/PA</span>
Photograph: Peter Byrne/PA

NHS may struggle with future numbers, researchers warn, due to large pool of undiagnosed people


Almost 300,000 people in the UK have aortic valve stenosis, a potentially deadly heart condition, according to the first major study to estimate its prevalence.

The NHS would struggle to cope with the sheer number of people needing treatment for this over the next few years, with the number set to rise further, the researchers warned.

More than half of those with advanced forms of the disease were likely to die within five years if they did not have timely, proactive treatment, they added. Their findings were published in the specialist BMJ journal Open Heart.

Aortic stenosis happens when the aortic valve, the main outflow valve of the heart, stiffens and narrows. This means it can no longer open fully, reducing or blocking blood flow from the heart into the aorta and to the rest of the body.

In a significant proportion of people, the condition remains “silent”, with symptoms appearing only when it is already at an advanced stage. Given the ageing of the UK population, it is thought that there may be a large pool of as yet undiagnosed people who might benefit from life-saving treatment.

The study involved researchers from NHS England, the University of Glasgow, the University of Southampton and the University of Notre Dame Australia, as well as cardiologists and surgeons in Manchester, Sheffield and Edinburgh.

“To our knowledge, this is the first study to specifically estimate the treatable burden of disease associated with severe, symptomatic AS [aortic stenosis] within the UK population,” the authors wrote. “Largely driven by an ageing postwar population cohort, we estimate that close to 300,000 adults are currently living with this potentially deadly condition at any one time. Critically, such an indicative burden is far greater than the current capacity within the NHS to screen, detect, triage and treat such cases.”

The researchers estimated that the overall prevalence of aortic stenosis among the over-55s in the UK in 2019 was almost 1.5%, equal to just under 300,000 people living with the potentially deadly condition at any one time.

Of the total numbers with aortic stenosis, 199,000 (68%) had severe disease in 2019, according to the study. However, the 92,000 with asymptomatic disease, representing almost a third of all cases (32%), would probably not be diagnosed unless they were being proactively screened for aortic stenosis or undergoing tests for another heart problem, the researchers suggested.

If someone has aortic valve disease, they may not experience any symptoms at first, according to the NHS, but the condition can eventually become more severe and cause chest pain, shortness of breath, dizziness, lightheadedness or fainting.

In particularly serious cases, the condition can lead to life-threatening problems such as heart failure. If the symptoms become more severe, patients often need surgery to replace the valve. Without treatment, severe aortic valve disease is likely to get worse and may eventually be fatal.

The researchers acknowledged that they had no way of verifying their estimates, advising that population data on the incidence and prevalence of aortic stenosis in the UK was inadequate and therefore their findings should be interpreted cautiously.

“In conclusion, this study suggests that severe AS [aortic stenosis] is a common condition affecting many individuals within the UK population aged over 55 years,” they wrote. “Without appropriate detection and intervention, their survival prospects are likely to be poor.”

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