Impacto da hipertensão arterial no remodelamento ventricular, em pacientes com estenose aórtica

Hueb, João Carlos; Vicentini, João T. R.; Roscani, Meliza Goi; Fusco, D.; Mattos, Ricaro; Zanatti, Silméia Garcia; Okoshi, Katashi; Matsubara, Beatriz Bojikian

doi:10.1590/s0066-782x2011005000081

Cited by 6 publications

(1 citation statement)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…5 6 13-18 However, pressure overload due to hypertension also may result in increased LV mass, mask pressure gradient and lead to low-gradient severe AS. [19][20][21] Globally, the ageing population has led to an increased prevalence of hypertension, and the combination of AS and hypertension can accelerate need for aortic valve replacement (AVR). [22][23][24][25][26][27][28][29][30] Consequently, LVH regression is a potential therapeutic target in AS.…”

Section: Introductionmentioning

confidence: 99%

Antihypertensive therapies in moderate or severe aortic stenosis: a systematic review and meta-analysis

et al. 2020

View full text Add to dashboard Cite

BackgroundHypertension confers a poor prognosis in moderate or severe aortic stenosis (AS), however, antihypertensive therapy (AHT) is often not prescribed due to the perceived deleterious effects of vasodilation and negative inotropes.ObjectiveTo assess the efficacy and safety outcomes of AHT in adults with moderate or severe AS.DesignSystematic review and meta-analysis.Data sourcesThe Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and grey literature were searched without language restrictions up to 9 September 2019.Study eligibility criteria, appraisal and synthesis methodsTwo independent reviewers performed screening, data extraction and risk of bias assessments from a systematic search of observational studies and randomised controlled trials comparing AHT with a placebo or no AHT in adults with moderate or severe AS for any parameter of efficacy and safety outcomes. Conflicts were resolved by the third reviewer. Meta-analysis with pooled effect sizes using random-effects model, were estimated in R.Main outcome measuresMortality, Left Ventricular (LV) Mass Index, systolic blood pressure, diastolic blood pressure and LV ejection fractionResultsFrom 3025 publications, 31 studies (26 500 patients) were included in the qualitative synthesis and 24 studies in the meta-analysis. AHT was not associated with mortality when all studies were pooled, but heterogeneity was substantial across studies. The effect size of AHT differed according to drug class. Renin–angiotensin–aldosterone system inhibitors (RAASi) were associated with reduced risk of mortality (Pooled HR 0.58, 95% CI 0.43 to 0.80, p=0.006), The differences in changes of haemodynamic or echocardiographic parameters from baseline with and without AHT did not reach statistical significance.ConclusionAHT appears safe, is well tolerated. RAASi were associated with clinical benefit in patients with moderate or severe AS.

show abstract