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Acquired valvular heart disease (VHD) is common in the 21st century and its prevalence is increasing, mainly due to increasing longevity associated with the progression of age-related degenerative changes as well as the rising prevalence of rheumatic heart disease.1 Cross-sectional epidemiological studies in the general adult population (mean age: 55 years) have shown a prevalence of approximately 2.5%, remarkably similar in Hispanic Americans and in the Chinese population.2 3 A recent American study reported the population prevalence of at least moderate valve disease of 8.2% in individuals aged 65–85 years, with nearly a threefold increase between the oldest and the youngest age quartiles (a 15-year difference) as reported by the PREVUE-VALVE Investigators (Age and Sex-Specific Prevalence of Acquired Valvular Heart Disease, NCT 05357404).4 When mild-to-moderate valvular disease is included, the prevalence more than doubles, identifying over 18% of this age group as a population at risk for, or already at, severe valve disease. In this study, the males over 75 years showed a particularly pronounced increase in significant VHD, especially tricuspid regurgitation.