Aortic Stenosis Mortality Declined Modestly but Disparities Persist, Study
A comprehensive 25-year national database study has revealed that mortality related to aortic stenosis among older adults in the United States experienced a modest reduction between 1999 and 2024. The study concluded that aortic stenosis-related mortality declined modestly among older adults from 1999 to 2024, though notable demographic and regional disparities persisted, including higher mortality in men, non-Hispanic White individuals, adults aged 85 years or older, and residents of nonmetropolitan regions and the Midwest. Aortic stenosis represents a primary cause of cardiovascular morbidity and mortality, characterized by progressive narrowing and calcification of the aortic valve orifice that impairs left ventricular outflow. The study was published in the JSCAI by Aymen A. and colleagues.
In order to assess long-term national trends, a retrospective population-based observational study was conducted by researchers that utilized official mortality data obtained from the CDC WONDER database. In this study, the subjects were all those deaths resulting from aortic stenosis among adult U.S. population aged 65 and above, during the period 1999-2024. Age-adjusted mortality rate (AAMR) was computed per 100,000 population and the average annual percent change (AAPC) for different demographics, age groups, urban-rural classification and census regions. The temporal variations and changes after year 2018 were statistically assessed through the use of Joinpoint regression technique.
Key findings:
- A total of 637,178 deaths were recorded, with overall AAMR decreasing significantly from 55.74 in 1999 to 52.46 in 2024 (AAPC –0.23, P = .004). Following an uptick between 2018 and 2021, mortality declined sharply through 2024 (annual percent change –2.40).
- Men maintained consistently higher AAMRs than women; mortality remained stable in men (AAPC –0.06, P = .33), but declined significantly among women (AAPC –0.35, P = .002).
- Mortality rates decreased among individuals aged 75 to 84 years, but increased significantly in adults aged 85 years and older (AAPC 0.28), who suffered the highest overall AAMR throughout the study period.
- AAMR declined across all census regions except the Midwest, which reached the highest regional AAMR in 2024 at 60.91; nonmetropolitan regions experienced rising mortality trends compared to declining rates in metropolitan cities.
- Non-Hispanic White individuals maintained the highest AAMR overall, whereas significant mortality reductions occurred among Hispanic/Latino and non-Hispanic Asian/Pacific Islander cohorts.
To summarize, the mortality rate of aortic stenosis in older adults within the US saw a modest decrease from 1999 through 2024. Yet, the issue of high mortality rates in men, non-Hispanic Whites, those 85 years old or older, rural people, and Midwesterners persists and indicates major existing healthcare inequalities. Special public health programs and infrastructure development are necessary for optimal survival chances of all older patients.
Reference:
Ahmed, A., Shakoor, M., Kamal, U. H., Sohail, H., Mankani, M. H., Jaiswal, V., Saqib, N. U., Nso, N., Qamar, A., & Ricciardi, M. J. (2026). Trends and Disparities in Aortic Stenosis–Related Mortality Among Adults Aged ≥65 Years in the United States From 1999 to 2024. Journal of the Society for Cardiovascular Angiography & Interventions, 105573. https://doi.org/10.1016/j.jscai.2026.105573
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