First Department of Cardiology, 'Hippokration' Hospital, University of Athens, Medical School, 21 Orfanidou Street, 11142, Athens, Greece.
Department of Cardiology, 'Evaggelismos' General Hospital, Athens, Greece.
Curr Hypertens Rep. 2019 Feb 28;21(3):20. doi: 10.1007/s11906-019-0928-9.
To review medical literature for evidence of association between hypertension and mitral regurgitation (MR) and summarize potential favorable effects of antihypertensive drugs on MR natural history and treatment.
Hypertension and MR are common diseases affecting a large proportion of the general population. Contemporary evidence suggests that hypertension may worsen the progression and prognosis of MR through augmented mechanical stress and increased regurgitation volume. Renin-angiotensin axis inhibitors, beta-blockers, and vasodilators have been tested in order to prevent or decrease primary or secondary MR. Although antihypertensive agents may improve hemodynamic parameters and left ventricular remodeling in primary MR, there is no strong evidence of benefit on clinical outcomes. On the other hand, a beneficial effect of these drugs on secondary MR is better established. Moreover, there are no studies evaluating a possible benefit of lower blood pressure targets in MR. Randomized controlled trials are warranted to elucidate the precise role of antihypertensive therapy on treatment of MR.
回顾医学文献中高血压与二尖瓣反流（MR）之间关联的证据，并总结降压药物对 MR 自然病程和治疗的潜在有利影响。
高血压和 MR 是常见疾病，影响着很大一部分普通人群。目前的证据表明，高血压可能通过增加机械应力和反流量使 MR 恶化。已经对肾素-血管紧张素轴抑制剂、β受体阻滞剂和血管扩张剂进行了测试，以预防或减少原发性或继发性 MR。虽然降压药物可能改善原发性 MR 的血流动力学参数和左心室重构，但在临床结局方面没有强有力的获益证据。另一方面，这些药物对继发性 MR 的有益作用已得到更好的确立。此外，尚无研究评估降低 MR 血压目标值的可能获益。需要进行随机对照试验来阐明降压治疗在 MR 治疗中的确切作用。
