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Management of patients with combined arterial hypertension and aortic valve stenosis : a consensus document from the Council on Hypertension and Council on Valvular Heart Disease of the European Society of Cardiology, the European Association of Cardiovascular Imaging (EACVI), the European Association of Percutaneous Cardiovascular Interventions (EAPCI)

Mancusi, Costantino (author)
de Simone, Giovanni (author)
Brguljan Hitij, Jana (author)
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Sudano, Isabella (author)
Mahfoud, Felix (author)
Parati, Gianfranco (author)
Kahan, Thomas (author)
Karolinska Institutet
Barbato, Emanuele (author)
Pierard, Luc A. (author)
Garbi, Madalina (author)
Flachskampf, Frank, 1957- (author)
Uppsala universitet,Klinisk fysiologi,Kardiologi
Gerdts, Eva (author)
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 (creator_code:org_t)
2020-04-30
2021
English.
In: European Heart Journal - Cardiovascular Pharmacotherapy. - : Oxford University Press. - 2055-6837 .- 2055-6845. ; 7:3, s. 242-250
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  • Journal article (other academic/artistic)
Abstract Subject headings
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  • Aortic valve stenosis (AS) is the third most common cardiovascular disease. The prevalence of both AS and arterial hypertension increases with age, and the conditions therefore often co-exist. Co-existence of AS and arterial hypertension is associated with higher global left ventricular (LV) pressure overload, more abnormal LV geometry and function, and more adverse cardiovascular outcome. Arterial hypertension may also influence grading of AS, leading to underestimation of the true AS severity. Current guidelines suggest re-assessing patients once arterial hypertension is controlled. Management of arterial hypertension in AS has historically been associated with prudence and concerns, mainly related to potential adverse consequences of drug-induced peripheral vasodilatation combined with reduced stroke volume due to the fixed LV outflow obstruction. Current evidence suggests that patients should be treated with antihypertensive drugs blocking the renin-angiotensin aldosterone system, adding further drug classes when required, to achieve similar target blood pressure values as in hypertensive patients without AS. The introduction of trans-catheter aortic valve implantation has revolutionized the management of patients with AS, but requires proper blood pressure management during and following valve replacement. The purpose of this document is to review the recent evidence and provide practical expert advice on management of hypertension in patients with AS.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Keyword

Aortic valve stenosis
aortic valve calcification
aortic valve replacement
arterial hypertension
cardiovascular risk
drug therapy
left ventricular hypertrophy
prognosis
Kardiologi
Cardiology

Publication and Content Type

vet (subject category)
art (subject category)

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