What Age Do People Get Aortic Insufficiency?

Oct 24, 2025 3 min read •

cardiology Heart Health Valvular Disease

The prevalence of aortic insufficiency increases with age, affecting approximately 2.0-2.3% of people over 70 in the U.S. population, though it can also affect younger individuals due to congenital conditions. The specific age at which someone develops this condition depends on the underlying cause, ranging from birth defects to age-related degenerative changes.

Quick Summary

Aortic insufficiency, or regurgitation, varies in onset depending on the cause, which can be congenital or acquired. Degenerative disease in older adults is common, while conditions like bicuspid valves and rheumatic fever affect younger individuals. Symptoms often appear in later stages, highlighting the importance of regular cardiovascular monitoring.

Key Points

Age is a primary factor for degenerative aortic insufficiency: The prevalence of the condition significantly increases in individuals over 60, as calcium deposits stiffen the valve over time.
Congenital defects affect younger patients: Those born with a bicuspid aortic valve often develop aortic insufficiency in their 40s and 50s, a decade or two earlier than cases linked to degenerative disease.
Infections can cause acute cases at any age: Infectious endocarditis can rapidly damage the aortic valve, leading to acute aortic insufficiency that can affect people regardless of their age.
Systemic diseases like Marfan syndrome play a role: Connective tissue disorders or systemic diseases can lead to aortic dilation and insufficiency, often seen in younger patients.
Symptoms usually appear in later, more severe stages: Many people with mild aortic insufficiency are asymptomatic for years, which can delay diagnosis until the condition has progressed.
Diagnosis is crucial for guiding intervention: The timing and type of intervention, whether medical management or surgery, are determined by the severity, symptoms, and progression, which are monitored with tests like echocardiograms.

Aortic insufficiency, also known as aortic regurgitation, is a condition where the aortic valve does not close tightly, allowing blood to leak back into the heart's left ventricle. This forces the heart to work harder to pump blood to the body, and if left untreated, can lead to serious complications like heart failure. While aging is a major factor, with incidence and severity increasing substantially with advancing age, numerous other factors contribute to its onset across a wide range of ages.

Age-Related Onset: The Role of Degenerative Disease

In developed countries, the most common cause of aortic valve disease in older individuals is degenerative calcification and wear-and-tear. As people age, the flaps of the aortic valve can become thick and stiff due to calcium buildup, which prevents them from closing properly.

The prevalence of moderate or greater aortic regurgitation is significantly higher in the elderly.
Studies show the prevalence increases from a low percentage in individuals in their 50s and 60s to several percent in those aged 70 and older.
This progression is often insidious, meaning the condition develops slowly over many years.

Symptoms typically do not manifest until the disease becomes more severe, which is why older individuals are often diagnosed after years of asymptomatic progression. Regular check-ups and monitoring are crucial for detecting the condition in its early stages in this population.

Congenital Causes: From Infancy to Adulthood

Some people are born with heart defects that affect the aortic valve, predisposing them to aortic insufficiency from a young age. The most common congenital abnormality is a bicuspid aortic valve, which has two leaflets instead of the normal three.

Bicuspid Aortic Valve (BAV): Affecting up to 2% of the population, BAV can cause significant aortic insufficiency and often requires intervention at a younger age than degenerative cases.
Valve Repair: For some with BAV, a leaky valve may be repaired surgically to restore proper function.
Mean Age of Surgery: The average age for BAV patients needing surgery is typically under 50, contrasting with the much older age group affected by degenerative disease.

It is important to note that a bicuspid valve may function well for many years before becoming problematic, but it increases the long-term risk of developing insufficiency.

Acquired Causes: Infections and Systemic Diseases

Other causes can lead to aortic insufficiency at any age, including infections and connective tissue disorders. These causes can trigger both acute and chronic forms of the condition.

Infectious Endocarditis: This is an infection of the heart's inner lining and valves, and it can cause rapid and severe damage to the aortic valve, leading to acute aortic insufficiency. This requires immediate medical attention.
Rheumatic Heart Disease: A complication of untreated strep throat, rheumatic fever can cause inflammation and scarring of the heart valves. This can result in aortic insufficiency, especially in children and young adults in developing countries.
Connective Tissue Disorders: Conditions like Marfan syndrome and lupus can lead to a dilated aorta, which stretches the valve and prevents proper closure. This often affects younger patients and can lead to significant aortic insufficiency.

Comparison of Aortic Insufficiency Onset


Feature	Degenerative (Age-Related)	Congenital (e.g., Bicuspid Valve)	Acquired (e.g., Infection)
Typical Age of Onset	Typically 60 and older	Present at birth, but symptoms may appear in early adulthood or later	Any age, depending on exposure
Speed of Onset	Gradual and insidious	Variable; can be slow or more rapid	Acute (sudden) or chronic
Primary Cause	Calcification and age-related wear-and-tear	Inherited heart valve abnormality	Infection (endocarditis, rheumatic fever), disease (lupus, Marfan syndrome), or trauma
Associated Factors	Male gender and other cardiovascular risk factors	Aortopathy (aortic dilation)	Untreated infections, systemic inflammatory conditions

Conclusion

The question of what age do people get aortic insufficiency has no single answer, as the condition can stem from various causes that manifest at different life stages. While degenerative valve disease makes it more common in the elderly, congenital issues like a bicuspid valve can affect people much younger. Acquired causes, including infections or systemic illnesses, can trigger the condition at any age. Regular medical checkups and timely echocardiography are essential for monitoring at-risk individuals and for managing the condition once diagnosed, regardless of the patient's age. This proactive approach can help prevent the condition from progressing to severe stages and requiring invasive interventions.

Frequently Asked Questions

No, while degenerative aortic insufficiency is more common in older adults, the condition can also affect younger individuals. Causes in younger people include congenital defects like a bicuspid aortic valve, as well as infections such as rheumatic fever or endocarditis.

Yes, some people are born with congenital heart defects that cause or predispose them to aortic insufficiency. The most common of these is a bicuspid aortic valve, which has two leaflets instead of the typical three.

Degenerative aortic insufficiency often develops gradually with age due to wear and tear and calcification. Most patients with this age-related cause are diagnosed in their 60s and 70s or later, as symptoms typically do not appear until the condition is severe.

Infections like rheumatic fever can cause the heart valves to become inflamed and scarred. This damage, known as rheumatic heart disease, can lead to the valve becoming leaky and can affect children and young adults, particularly in developing countries.

Marfan syndrome is a connective tissue disorder that can cause dilation of the aorta. When the aorta enlarges, it can stretch the attached aortic valve, preventing it from closing completely and leading to significant insufficiency.

The heart has a remarkable ability to compensate for a leaky aortic valve for many years. As a result, symptoms like fatigue and shortness of breath may not appear until the heart is significantly strained and the condition has become severe.

Yes, early detection and timely intervention are critical for improving patient outcomes. Recent studies show that surgical intervention, such as aortic valve replacement, can provide a significant survival benefit for patients with symptomatic aortic insufficiency.

References

Medical Disclaimer

This content is for informational purposes only and should not replace professional medical advice. Always consult a qualified healthcare provider regarding personal health decisions.