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Antihypertensive Treatment in Severe Aortic Stenosis
1Division of Cardiology, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea.
Journal of Cardiovascular Imaging
|July 5, 2018
Summary
Antihypertensive treatment, once cautioned against in severe aortic stenosis (AS), may now be safe and beneficial. Recent studies suggest it can reduce left ventricular pressure overload and slow AS progression, though guidelines are lacking.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Severe aortic stenosis (AS) historically contraindicates antihypertensive therapy due to concerns of left ventricular dysfunction.
- Recent evidence suggests potential benefits of antihypertensive treatment in severe AS, including reduced pressure overload and slowed valvular progression.
Purpose of the Study:
- To review the current understanding and evidence regarding antihypertensive treatment in severe aortic stenosis.
- To explore the potential roles of specific drug classes, such as beta-blockers and renin-angiotensin system inhibitors, in managing severe AS.
Main Methods:
- Review of recent clinical studies and experimental models concerning antihypertensive treatment in severe aortic stenosis.
- Analysis of the physiological effects of antihypertensive agents on left ventricular function and valvular disease progression.
Main Results:
- Beta-blocker use, previously avoided, may be safe and beneficial in severe AS.
- Renin-angiotensin system (RAS) inhibition shows theoretical and emerging clinical benefits in retarding AS progression and aiding left ventricle remodeling.
Conclusions:
- Antihypertensive treatment, particularly RAS inhibition, may be beneficial in severe aortic stenosis.
- Further randomized clinical trials are essential to establish optimal blood pressure targets and antihypertensive regimens for severe AS.
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