Associations between sweetened beverage consumption, degenerative valvular heart disease, and related events: a prospective study from UK Biobank

Abstract Aims There are no effective medications to prevent the onset of degenerative valvular heart disease (VHD). Sweetened beverage consumption may contribute to the development of VHD by affecting metabolic disorders, systemic inflammation, and calcification processes. This study aimed to prospectively assess the association between sweetened beverage consumption and the risk of degenerative VHD. Methods and results This prospective study included 167,801 participants from the UK Biobank who completed at least one dietary questionnaire. During a median follow-up of 14.53 years, 1,464 cases of aortic valve stenosis (AS) events, 584 cases of aortic valve regurgitation (AR) events, and 1,744 cases of mitral valve regurgitation (MR) events were recorded. Compared with non-consumers, participants consuming more than one drink per day of artificially sweetened beverages (ASBs) had a higher risk of AS (HR: 1.36, 95% CI: 1.10-1.68), AR (HR: 1.42, 95% CI: 1.02-2.00), MR (HR: 1.35, 95% CI: 1.10-1.64). Similarly, the consumption of more than one drink of sugar-sweetened beverages (SSBs) was associated with an increased incidence of MR (HR: 1.47, 95% CI: 1.22–1.77). In contrast, no significant association was observed between the consumption of natural juices (NJs) and VHD risk. Results for VHD-related interventions, deaths, or cardiovascular events were largely consistent. Substituting SSBs or ASBs per day with NJs was associated with a reduced risk of MR (HR: 0.83, 95% CI: 0.72-0.94) events or AS (HR: 0.81, 95% CI: 0.69-0.94) events, respectively. Conclusions Lower consumption of SSBs or ASBs may reduce the risk of degenerative VHD and VHD-related events.