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Published on: October 20, 2023
Hypertension and Aortic Stenosis: A Review
1Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, United States.
Insights
Treating hypertension in patients with aortic stenosis is complex. Angiotensin-converting enzyme (ACE) inhibitors are the most studied agents for managing high blood pressure in these patients.
Area of Science:
- Cardiology
- Internal Medicine
- Pharmacology
Background:
- Aortic stenosis and hypertension frequently coexist, presenting distinct left ventricular systolic overload.
- Combined conditions can lead to adverse left ventricular remodeling, increased mortality, and heart failure.
- Managing hypertension in aortic stenosis patients poses clinical challenges due to limited evidence.
Purpose of the Study:
- To review the pathophysiology of combined aortic stenosis and hypertension.
- To examine the impact on left ventricular remodeling.
- To provide recommendations for antihypertensive therapy in this patient population.
Main Methods:
- A comprehensive online literature review was conducted.
- Relevant published literature on hypertension and aortic stenosis was identified and analyzed.
Main Results:
- The manuscript reviews the pathophysiology and effects of combined aortic stenosis and hypertension on the left ventricle.
- General recommendations for medical therapy are provided.
- Data on specific antihypertensive agents were reviewed.
Conclusions:
- Coexisting aortic stenosis and hypertension complicate diagnosis and symptom assessment.
- Treating hypertension in severe aortic stenosis is challenging.
- Angiotensin-converting enzyme (ACE) inhibitors are the most studied antihypertensive agents in this context.
Background:
Aortic stenosis is a common form of valvular heart disease which often coexists with hypertension. These diseases represent two distinct forms of left ventricular systolic overload and in combination may be associated with disadvantageous left ventricular remodeling, increased mortality and heart failure. The treatment of hypertension in aortic stenosis remains a challenging problem with limited data to guide clinical practice.
Methods:
We performed a comprehensive online literature review to find relevant published literature on the topic of hypertension and aortic stenosis.
Results:
In the present manuscript, we review the pathophysiology of aortic stenosis in combination with hypertension and the effects on the left ventricle. We also provide general recommendations for medical therapy for treatment of hypertension in aortic stenosis and review the available data on specific antihypertensive agents in this context.
Conclusions:
Aortic stenosis and hypertension commonly coexist and significantly impact the diagnosis and classification of aortic stenosis severity and symptoms. Treatment of hypertension among patients with severe aortic stenosis can be challenging. Among specific antihypertensive agents studied in this context, ACE-inhibitors are the most well studied.
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