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Aortic Stenosis, Aortic Regurgitation and Arterial Hypertension
V Katsi1, G Georgiopoulos1, D Oikonomou2
1First Department of Cardiology, 'Hippokration' Hospital, University of Athens, Medical School, Athens, Greece.
Insights
Hypertension (high blood pressure) is common in patients with aortic valve disease and linked to worse outcomes. Prompt treatment of hypertension is recommended, and some blood pressure medications may help manage aortic conditions.
Area of Science:
- Cardiology
- Vascular Medicine
- Clinical Research
Background:
- Hypertension (HT) is a significant risk factor for cardiovascular disease.
- HT may precipitate aortic valve pathology, including stenosis and regurgitation.
Purpose of the Study:
- To investigate the association between HT and aortic dysfunction (regurgitation and stenosis).
- To assess the impact of antihypertensive treatment on aortic disease progression.
Main Methods:
- Systematic literature review.
- Analysis of articles correlating HT with aortic disease phenotypes.
Main Results:
- HT is highly prevalent in patients with aortic stenosis and regurgitation, predicting worse prognosis.
- Some antihypertensive agents may improve hemodynamic parameters and left ventricular remodeling.
- Renin-angiotensin system inhibitors are well-tolerated in aortic stenosis.
Conclusions:
- Evidence supports a detrimental association between HT and aortic valve disease.
- Prompt treatment of HT is crucial in patients with aortic valvulopathy.
- Specific vasodilators can be cautiously used in aortic stenosis.
Background:
Hypertension (HT) is an important risk factor for cardiovascular disease and might precipitate pathology of the aortic valve.
Objective:
To investigate the association of HT with aortic dysfunction (including both aortic regurgitation and stenosis) and the impact of antihypertensive treatment on the natural course of underlying aortic disease.
Methods:
We performed a systematic review of the literature for all relevant articles assessing the correlation between HT and phenotype of aortic disease.
Results:
Co-existence of HT with aortic stenosis and aortic regurgitation is highly prevalent in hypertensive patients and predicts a worse prognosis. Certain antihypertensive agents may improve haemodynamic parameters (aortic jet velocity, aortic regurgitation volume) and remodeling of the left ventricle, but there is no strong evidence of benefit regarding clinical outcomes. Renin-angiotensin system inhibitors, among other vasodilators, are well-tolerated in aortic stenosis.
Conclusion:
Several lines of evidence support a detrimental association between HT and aortic valve disease. Therefore, HT should be promptly treated in aortic valvulopathy. Despite conventional wisdom, specific vasodilators can be used with caution in aortic stenosis.
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