Objectives This study aims to systematically analyze global, regional, and national trends in the incidence, mortality, and disability-adjusted life years (DALYs) of rheumatic heart disease (RHD) and non-rheumatic valvular heart disease (NRVHD) from 1990 to 2021, and to project future trends through 2036 using data from the Global Burden of Disease Study 2021. Methods Data were extracted from the Global Health Data Exchange and stratified by age, sex, and socio-demographic index (SDI). The analysis included cases, deaths, mortality rates, DALYs, and age-standardized rates (ASIR, ASMR, and ASDR) for both RHD and NRVHD. Projections for 2022–2036 were made using the ARIMA model. Results In 2021, the global incidence of RHD was estimated at 3.85 million cases (95% UI: 3,056,084.82–4,783,797.73), with a higher prevalence among females (53.41%). RHD accounted for 373,345 deaths (95% UI: 324,139.65–444,761.76), with females comprising 56.98% of these. DALYs due to RHD totaled 13.43 million (95% UI: 11,517,020.93–15,780,163.69), with females representing 55.05%. The incidence of NRVHD reached 2.21 million cases (95% UI: 2,048,266.87–2,375,325.37), predominantly among males (60.17%). However, NRVHD-related deaths totaled 181,078 (95% UI: 155,363.66–195,716.85), with females accounting for a higher proportion (58.79%). DALYs due to NRVHD reached 3.24 million (95% UI: 2,934,104.15–3,594,473.74). From 1990 to 2021, RHD mortality declined in high-income countries but remained a major cause of death in low- and middle-income countries. In contrast, both the incidence and mortality of NRVHD increased significantly, particularly in high-income countries, driven by aging populations and lifestyle-related risk factors. Conclusion This study underscores the substantial global burden of RHD and NRVHD. RHD disproportionately affects younger populations in low- and middle-income countries, while NRVHD is increasingly prevalent among older adults in high-income countries. Early diagnosis and timely intervention are essential to mitigating the worldwide impact of these conditions. <Table Float="No" ID="Taba"> <tgroup cols="2"> <colspec align="left" colname="c1" colnum="1" /> <colspec align="left" colname="c2" colnum="2" /> <tbody> <row> <entry align="left" nameend="c2" namest="c1"> Key Points • Systematically analyzes global trends of RHD and NRVHD from 1990 to 2021 and projected to 2036. • RHD remains prevalent in younger populations in low- and middle-income countries. • NRVHD is rising among older adults in high-income regions. </entry> </row> </tbody> </tgroup> </Table>

Global burden of rheumatic vs non-rheumatic valvular heart disease, 1990–2021: a systematic analysis of the global burden of disease study

期刊论文
发表日期：

2025年10月13日

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Huirui Tang,
Kexin Zhang,
Jinyan Chen,
Xiaofei Zhang,
Xiao Yu,
Jiayi Ren,
Yuqun Wang,
Yujie Ma,
Ningning Hou,
Chengxia Kan,
Xiaodong Sun

摘要

Objectives

This study aims to systematically analyze global, regional, and national trends in the incidence, mortality, and disability-adjusted life years (DALYs) of rheumatic heart disease (RHD) and non-rheumatic valvular heart disease (NRVHD) from 1990 to 2021, and to project future trends through 2036 using data from the Global Burden of Disease Study 2021.

Methods

Data were extracted from the Global Health Data Exchange and stratified by age, sex, and socio-demographic index (SDI). The analysis included cases, deaths, mortality rates, DALYs, and age-standardized rates (ASIR, ASMR, and ASDR) for both RHD and NRVHD. Projections for 2022–2036 were made using the ARIMA model.

Results

In 2021, the global incidence of RHD was estimated at 3.85 million cases (95% UI: 3,056,084.82–4,783,797.73), with a higher prevalence among females (53.41%). RHD accounted for 373,345 deaths (95% UI: 324,139.65–444,761.76), with females comprising 56.98% of these. DALYs due to RHD totaled 13.43 million (95% UI: 11,517,020.93–15,780,163.69), with females representing 55.05%. The incidence of NRVHD reached 2.21 million cases (95% UI: 2,048,266.87–2,375,325.37), predominantly among males (60.17%). However, NRVHD-related deaths totaled 181,078 (95% UI: 155,363.66–195,716.85), with females accounting for a higher proportion (58.79%). DALYs due to NRVHD reached 3.24 million (95% UI: 2,934,104.15–3,594,473.74). From 1990 to 2021, RHD mortality declined in high-income countries but remained a major cause of death in low- and middle-income countries. In contrast, both the incidence and mortality of NRVHD increased significantly, particularly in high-income countries, driven by aging populations and lifestyle-related risk factors.

Conclusion

This study underscores the substantial global burden of RHD and NRVHD. RHD disproportionately affects younger populations in low- and middle-income countries, while NRVHD is increasingly prevalent among older adults in high-income countries. Early diagnosis and timely intervention are essential to mitigating the worldwide impact of these conditions.

Key Points

• Systematically analyzes global trends of RHD and NRVHD from 1990 to 2021 and projected to 2036.

• RHD remains prevalent in younger populations in low- and middle-income countries.

• NRVHD is rising among older adults in high-income regions.