Pavilion Health Today
Supporting healthcare professionals to deliver the best patient care

NHS will soon struggle to cope with volume of patients with heart valve disease, say experts

Experts are warning that the NHS will soon struggle to cope with the volume of patients with aortic valve stenosis, after research revealed that 300,000 people in the UK have the potentially fatal condition.

Experts are warning that the NHS will soon struggle to cope with the volume of patients with aortic valve stenosis, after research revealed that 300,000 people in the UK have the potentially fatal condition.

With the sheer number of people expected to need treatment for the condition in the next few years and the number set to rise as the population ages, experts are calling for interventions to be urgently taken.

Researchers say without timely, proactive treatment, over half of those with advanced disease will likely die within five years.

The researchers used population data to estimate the prevalence of the disease

The research, published in the journal Open Heart, therefore set out to provide informed estimates of the overall prevalence of severe aortic stenosis across the UK and how many people might benefit from surgery: surgical aortic valve replacement (SAVR) or transcatheter aortic valve implant (TAVI).

To gauge the numbers potentially at risk of aortic stenosis, the researchers obtained national age and sex-specific population data for the year 2019, when nearly a third (30%; 20.1 million) of the UK’s 66 million population were aged 55 and older.

To come up with valid and accurate age specific prevalence estimates, they drew on data from the NEDA study, one of the largest ever studies of the condition to date. This had come up with a prevalence of severe disease of 3.5% among the over 75s.

Using this as a reference point, they estimated the prevalence of severe aortic stenosis as 1.2% among 70-74-year olds; 0.7% among 65-69-year olds; 0.5% among 60-64-year olds; and 0.4% among 55-59-year olds in 2019.

They then estimated the proportions of those with and without symptoms, and of those with symptoms, how many could be managed with drugs and how many would need surgery, based on historical treatment patterns.

And they calculated how many people would die, if left untreated, based on the estimated total numbers of people diagnosed with the condition in 2019, and actual 5-year death rates observed among the untreated in the NEDA study.

A third of all cases present ‘silently’

Based on all these figures, the researchers estimate that the overall prevalence of severe aortic stenosis among the over 55s in the UK in 2019 to be almost 1.5%, equal to around 300,000 people living with this potentially deadly condition at any one time.

Of the total numbers with aortic stenosis, just under 200,000 (68%) had severe (symptomatic) disease in 2019, prompting the need for around 116,000 SAVR and 51,000 TAVI procedures, the researchers estimate.

But the 92,389 people with ‘silent’ disease, representing nearly a third of all cases (32%), will probably not be diagnosed unless they are being proactively screened for aortic stenosis or undergoing tests for another heart problem, they suggest.

Without timely proactive treatment up to 172,859 of those with severe aortic stenosis (59%, overall) in 2019 will die over the next five years to 2024, equal to 35,000 people every year.

Nearly 10,000 of these deaths (almost 6% of all cases) will be among 55-64-year olds, with an additional 29,548 deaths (17%) among 65-74-year olds. Most deaths will occur in 75-84-year olds (86,383; 50%) and the over 85s (47,121; 27%), the researchers estimate.

Unless appropriate detection and intervention methods are implemented, “survival prospects are likely to be poor”

In response to their findings, the researchers question whether the health service will be able to cope with the level of patients needing treatment. They said: “Critically, such an indicative burden is far greater than the current capacity within the NHS to screen, detect, triage and treat such cases.

“There seems little doubt, therefore, that there is a significant shortfall between interventions undertaken for severe [aortic stenosis] and our estimates of potential demand.”

With such a high prevalence, researchers warn that unless appropriate detection and intervention methods are implemented, “survival prospects are likely to be poor.”

This website uses cookies to improve your experience. We'll assume you're ok with this, but you can opt-out if you wish. Accept Read more ...

Privacy & Cookies Policy