High systolic BP tied to increased risk for major valve disease

  • Nazarzadeh M & al.
  • JAMA Cardiol
  • 10 Jul 2019

  • International Clinical Digest
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Takeaway

  • Increased systolic BP is a risk for valvular heart disease, with a 20-mmHg increase tied to tripled odds in genetically associated BP.

Why this matters

  • Pinning down modifiable risk factors for valvular heart disease has proved difficult, but targeting systolic BP reductions looks like a preventive avenue.

Key results

  • In this Mendelian analysis, systolic BP was linked to valvular heart disease, with each 20-mmHg increase tied to aORs (95% CIs) of:
    • Aortic stenosis: 3.26 (1.50-7.10);
    • Aortic regurgitation: 2.59 (0.75-8.92); 
    • Mitral regurgitation: 2.19 (1.07-4.47); and
    • For any valve disease: 2.85 (1.69-4.78).
  • Risks based only on clinical data were similarly increased, but not as steeply.
  • These findings held up on sensitivity analyses.

Study design

  • Analysis of data from the UK Biobank, including 329,237 people ages 40-96 years.
  • Single DNA changes were associated with systolic BP.
  • Funding: UK foundations, government.

Limitations

  • Low representation for some types of valve disease, so wide CIs.
  • Ethnically homogeneous population.