Calcific Aortic Valve Disease and Hypertension

Harsha      Dadlani; Narin      Osman; Mandy   L.   Ballinger; Silvana      Marasco; Peter   J.   Little

Abstract

This review addresses the role of hypertension in precipitating Calcific aortic valve disease (CAVD) and the therapeutic potential of anti-hypertensive interventions to ameliorate CAVD. CAVD was originally considered to be a degenerative disease representing the “wear and tear” of the aortic valves. More recently both conceptually and experimentally, CAVD has come to be considered the result of an active disease process. Whilst, there are some common factors in the pathology and risk factors for atherosclerosis and CAVD there are also some distinct differences. Hypertension is an established risk factor for coronary artery disease and has been recognised as a risk factor for CAVD. Angiotensin converting enzyme inhibitors have been found to have beneficial effects in CAVD and as in atherosclerosis such effects may be due to the blood pressure lowering action but also to direct pleiotropic effects on the biochemical and cellular mechanisms of disease progression in the respective tissues. The very high prevalence of hypertension in the community coupled with an aging population, a risk factor associated with both hypertension and CAVD, infers that hypertension will be one of the predominant factors that increase the impact of CAVD on human health in the coming decades.

Keywords: Calcific aortic valve disease, hypertension, atherosclerosis, angiotensin converting enzyme inhibitors

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