First Department of Cardiology, 'Hippokration' Hospital, University of Athens, Medical School, Athens, Greece.
Department of Cardiology, 'Evaggelismos' General Hospital, Athens, Greece.
Curr Vasc Pharmacol. 2019;17(2):180-190. doi: 10.2174/1570161116666180101165306.
Hypertension (HT) is an important risk factor for cardiovascular disease and might precipitate pathology of the aortic valve.
To investigate the association of HT with aortic dysfunction (including both aortic regurgitation and stenosis) and the impact of antihypertensive treatment on the natural course of underlying aortic disease.
We performed a systematic review of the literature for all relevant articles assessing the correlation between HT and phenotype of aortic disease.
Co-existence of HT with aortic stenosis and aortic regurgitation is highly prevalent in hypertensive patients and predicts a worse prognosis. Certain antihypertensive agents may improve haemodynamic parameters (aortic jet velocity, aortic regurgitation volume) and remodeling of the left ventricle, but there is no strong evidence of benefit regarding clinical outcomes. Renin-angiotensin system inhibitors, among other vasodilators, are well-tolerated in aortic stenosis.
Several lines of evidence support a detrimental association between HT and aortic valve disease. Therefore, HT should be promptly treated in aortic valvulopathy. Despite conventional wisdom, specific vasodilators can be used with caution in aortic stenosis.
高血压（HT）是心血管疾病的重要危险因素，可能引发主动脉瓣病理改变。
探讨 HT 与主动脉功能障碍（包括主动脉瓣反流和狭窄）的关系，以及降压治疗对潜在主动脉疾病自然病程的影响。
我们对所有评估 HT 与主动脉疾病表型相关性的相关文章进行了系统回顾。
高血压患者中 HT 与主动脉瓣狭窄和反流并存的发生率很高，且预示着预后更差。某些降压药物可能改善血液动力学参数（主动脉射流速度、主动脉瓣反流量）和左心室重构，但在临床结局方面，尚无强有力的获益证据。血管紧张素转换酶抑制剂等血管扩张剂在主动脉瓣狭窄中耐受良好。
多项证据支持 HT 与主动脉瓣疾病之间存在不良关联。因此，主动脉瓣病变应及时治疗 HT。尽管存在传统观念，但在主动脉瓣狭窄中仍可谨慎使用特定的血管扩张剂。
