Hypertension in aortic valve disease and its response to valve replacement

Abstract

Summary:We have investigated the prevalence of hypertension and the response of blood pressure to operation in 87 patients with lone aortic valve disease who underwent aortic valve replacement.In patients with aortic stenosis alone 26% were hypertensive pre-operatively (age and sex adjusted blood pressure > 160 systolic and or > 95 mmHg diastolic) and 24% were hypertensive post-operatively. In those with aortic regurgitation alone, hypertension was present in 65% before and 57% after valve replacement using the same criterion. For combined stenosis and regurgitation, the prevalence was 54% and 62%, respectively.The post-operative increase in systolic pressure in patients with aortic stenosis occurred mainly in those with a history of left ventricular failure. In those with aortic regurgitation or combined stenosis with regurgitation, diastolic pressure rose after valve replacement resulting in a prevalence of diastolic hypertension of 44% and 35%, respectively. Blood pressure changes were not predicted by the type of valve inserted nor its size.Our data show that despite severe symptomatic aortic valve disease, systolic hypertension was common in aortic stenosis and diastolic hypertension was found in aortic regurgitation. This underlines the importance of blood pressure monitoring in patients following aortic valve replacement.

Angiotensin receptor blockers are associated with a lower remodelling score of stenotic aortic valves

“…Calcific aortic valve stenosis (AS) is the most frequent cause of valvular heart disease in developed countries. Age, male gender, smoking, hypertension, metabolic syndrome and diabetes mellitus have been identified as clinical risk factors for the development of AS [1][2][3][4][5][6][7]. Studies conducted in the past decades have underlined that AS shares several similarities with vascular atherosclerosis including lipid infiltration of tissues [8,9], chronic inflammation [10,11], tissue remodelling and calcification [12,13].…”

Case of Refractory Hypertension Controlled After Aortic and Mitral Valve Replacement and Coronary Artery Bypass Grafting

“…Diastolic hypertension is more prevalent after aortic valve replacement for treatment of aortic regurgitation. Hypertension prevalence decreases from 65% to 57% after aortic valve replacement for aortic insufficiency 4…”

Lipoprotein lipase in aortic valve stenosis is associated with lipid retention and remodelling

“…Aortic valve stenosis or also termed calcific aortic valve disease (CAVD) is a chronic disorder characterized by a fibrocalcific remodelling of the aortic valve . Different risk factors have been identified and associated with CAVD including age, hypertension, diabetes and metabolic syndrome . Despite the fact that lipids, including oxidized low‐density lipoprotein (ox‐LDL), are present within stenotic aortic valves , statins are not efficient to prevent the natural course of the disease, which is a relentless progression in a matter of years .…”