Hypertension in aortic stenosis implications for left ventricular structure and cardiovascular events

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Rieck, Åshild E.Institute of Medicine, University of Bergen, Bergen, Norway (author)

Hypertension in aortic stenosis implications for left ventricular structure and cardiovascular events

Article/chapterEnglish2012

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American Heart Association,2012
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LIBRIS-ID:oai:DiVA.org:umu-199718
https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-199718URI
https://doi.org/10.1161/HYPERTENSIONAHA.112.194878DOI

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Language:English
Summary in:English

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The impact of hypertension on left ventricular structure and outcome during progression of aortic valve stenosis has not been reported from a large prospective study. Data from 1616 patients with asymptomatic aortic stenosis randomized to placebo-controlled treatment with combined simvastatin and ezetimibe in the Simvastatin Ezetimibe in Aortic Stenosis Study were used. The primary study end point included combined cardiovascular death, aortic valve events, and ischemic cardiovascular events. Hypertension was defined as history of hypertension or elevated baseline blood pressure. Left ventricular hypertrophy was defined as left ventricular mass/height2 7 >46.7 g/m2.7 in women and >49.2 g/m2.7 in men and concentric geometry as relative wall thickness >043. Baseline peak aortic jet velocity and aortic stenosis progression rate did not differ between hypertensive (n= 1340) and normotensive (n=276) patients. During 4.3 years of follow-up, the prevalence of concentric left ventricular hypertrophy increased 3 times in both groups. Hypertension predicted 51% higher incidence of abnormal LV geometry at final study visit independent of other confounders (P<0.01). In time-varying Cox regression, hypertension did not predict increased rate of the primary study end point. However, hypertension was associated with a 56% higher rate of ischemic cardiovascular events and a 2-fold increased mortality (both P<0.01), independent of aortic stenosis severity, abnormal left ventricular geometry, in-treatment systolic blood pressure, and randomized study treatment. No impact on aortic valve replacement was found. In conclusion, among patients with initial asymptomatic mild-to-moderate aortic stenosis, hypertension was associated with more abnormal left ventricular structure and increased cardiovascular morbidity and mortality.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
Antihypertensive agents
Aortic valve stenosis
Echocardiography
Hypertension
Prognosis

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Cramariuc, DanaDepartment of Heart Disease, Haukeland University Hospital, Bergen, Norway (author)
Boman, KurtUmeå universitet,Avdelningen för medicin,Skellefteå Hospital, Skellefteå, Sweden(Swepub:umu)kubo0001 (author)
Gohlke-Bärwolf, ChristaHerz-Zentrum Bad Krozingen, Bad Krozingen, Germany (author)
Staal, Eva M.Department of Cardiology, Stavanger University Hospital, Stavanger, Norway (author)
Lønnebakken, Mai ToneInstitute of Medicine, University of Bergen, Bergen, Norway; Department of Heart Disease, Haukeland University Hospital, Bergen, Norway (author)
Rossebø, Anne B.Division of Cardiology, Aker University Hospital, Oslo, Norway (author)
Gerdts, EvaInstitute of Medicine, University of Bergen, 5021 Bergen, Norway; Department of Heart Disease, Haukeland University Hospital, Bergen, Norway (author)
Institute of Medicine, University of Bergen, Bergen, NorwayDepartment of Heart Disease, Haukeland University Hospital, Bergen, Norway (creator_code:org_t)

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In:Hypertension: American Heart Association60:1, s. 90-970194-911X1524-4563

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By the author/editor: Rieck, Åshild E.; Cramariuc, Dana; Boman, Kurt; Gohlke-Bärwolf, ...; Staal, Eva M.; Lønnebakken, Mai ...; show more...; Rossebø, Anne B.; Gerdts, Eva; show less...

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