World Cardiology Conference 2026

Abstract

Background
Valvular heart disease (VHD) has emerged as an escalating global and regional health challenge. This study aims to provide a comprehensive assessment of VHD mortality trends across Brazil, Russian Federation, India, China and South Africa (BRICS) from 1990 to 2021.

Methods
Data on VHD were obtained from the Global Burden of Disease 2021 Study. We calculated the relative proportion of VHD mortality to all-cause mortality across the BRICS. Age-period-cohort modelling was employed to estimate cohort and period effects in VHD from 1990 to 2021, and calculated net drift (overall annual percentage change), local drift (annual percentage change in each age group), longitudinal age curves (expected longitudinal age-specific rate), and period (cohort) relative risks.

Results
In 2021, there were a total of 274,773 VHD deaths across the BRICS, accounting for 49.72% of global VHD mortality. The age-standardized mortality rate (ASMR) of rheumatic heart disease (RHD) in BRICS remained far higher than that of high-income Asia Pacific countries, particularly in India (14.28 per 100 000 in 2021, 95% UI [11.79,19.00]). India and China continued to report the highest number of RHD deaths. Brazil and South Africa showed relatively effective performance in RHD management. Although the ASMR of Non-rheumatic valvular heart disease (NRVHD) in BRICS remained lower than that of high-income Asia Pacific countries, the total death number of NRVHD patients in BRICS increased by 179% from 1990 to 2021. Brazil and India faced most serious NRVHD mortality burdens among BRICS. Notably, the Russia was the only BRICS country with a positive net drift in NRVHD mortality, indicating a significant upward trend, especially among older cohorts born after 1952.
Conclusion The BRICS have made progress in RHD mortality; however, the overall improvements lag behind those observed in high-income Asia Pacific countries. Brazil and South Africa have demonstrated relatively strong performance in RHD management, offering valuable reference for other countries facing similar challenges. Meanwhile, Brazil and India are confronting most serious NRVHD mortality burdens among BRICS. To address these challenges, the BRICS, and other nations with high VHD burdens, should implement disease-specific, population-tailored interventions at different VHD groups in their individual country.