Aging increases the risk of heart valve disease primarily because the heart valves undergo gradual wear and tear over time, leading to structural and functional deterioration. As people grow older, their heart valves—especially the aortic and mitral valves—experience changes such as thickening, stiffening, and calcification. These changes reduce the valves’ ability to open and close properly, which can cause conditions like valve stenosis (narrowing) or regurgitation (leakage).
One key reason for this age-related valve degeneration is the accumulation of calcium deposits on the valve leaflets. This calcification process is similar to what happens in arteries during atherosclerosis and is driven by chronic inflammation, mechanical stress, and metabolic factors. Over decades, these calcium deposits make the valve leaflets less flexible and more prone to damage, impairing their function.
Additionally, aging is associated with changes in the cellular and molecular environment of the valves. Valvular interstitial cells, which maintain valve structure, can become dysregulated, promoting fibrosis (excess connective tissue) and calcification. Recent research has shown that microRNAs—small molecules that regulate gene expression—play a role in this process by influencing inflammation and calcification pathways in valve cells.
Other age-related factors contribute to valve disease risk. For example, the heart muscle may thicken (left ventricular hypertrophy) due to high blood pressure or other cardiovascular stresses common in older adults. This thickening increases mechanical strain on the valves, accelerating their degeneration. Moreover, systemic conditions that become more prevalent with age, such as diabetes, high cholesterol, and hypertension, exacerbate valve damage by promoting inflammation and vascular calcification.
The cumulative effect of these processes means that by the time people reach their 60s, 70s, and beyond, degenerative valve disease becomes much more common. The valves lose their normal structure and function, leading to symptoms like breathlessness, fatigue, and heart failure if untreated.
In summary, aging increases heart valve disease risk because of progressive mechanical wear, calcium buildup, cellular changes promoting fibrosis and calcification, and the influence of common age-related cardiovascular conditions that together impair valve integrity and function.