Takeaway
- Higher BP and pulse pressure (PP) are significantly associated with an increased risk for aortic valve stenosis (AS) or regurgitation (AR).
- The possible causal nature of the observed associations warrants further investigation.
Why this matters
- Few largely cross-sectional studies have reported a positive association between hypertension and risk for AS or AR. However, no large-scale longitudinal analysis of these associations across the complete range of typical BP levels has previously been reported.
Study design
- 5,392,183 patients with no known cardiovascular disease or aortic valve disease with a median follow-up of 9.2 years and a median age of 39 years were included.
- Primary outcomes were incident reports of AS or AR.
- Funding: Oxford Martin School grant.
Key results
- A total of 20,680 (0.38%) and 6440 (0.12%) were diagnosed with AS and AR, respectively.
- Each 20 mmHg increment in SBP was associated with a 1.41 times higher risk for AS (HR, 1.41; 95% CI, 1.38-1.45) and 1.38 times higher risk for AR (HR, 1.38; 95% CI, 1.31-1.45).
- Stronger associations were observed in younger patients (HR for AR; 1.86; 95% CI, 1.66-2.07) and for both AS and AR there was no strong evidence for interaction by sex or BMI categories.
- Each 10 mmHg increment in diastolic BP was associated with a 1.24 times higher risk for AS (HR 1.24; 95% CI, 1.19-1.29) but not significantly with AR (HR, 1.04; 95% CI, 0.97-1.11).
- Each 15 mmHg higher pulse pressure was associated with a 1.46 times higher risk for AS (HR, 1.46; 95% CI, 1.42-1.50), and a 1.53 times greater risk for AR (HR, 1.53; 95% CI, 1.45-1.62).
Limitations
- Observational design.
References
References
