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Repository of Research and Investigative Information

Torbat Heydariyeh University of Medical Sciences

Elevated blood pressure and risk of aortic valve disease: A cohort analysis of 5.4 million UK adults

(2018) Elevated blood pressure and risk of aortic valve disease: A cohort analysis of 5.4 million UK adults. European Heart Journal. pp. 3596-3603.

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Abstract

Aims To test two related hypotheses that elevated blood pressure (BP) is a risk factor for aortic valve stenosis (AS) or regurgitation (AR). Methods and results In this cohort study of 5.4 million UK patients with no known cardiovascular disease or aortic valve disease at baseline, we investigated the relationship between BP and risk of incident AS and AR using multivariable-adjusted Cox regression models. Over a median follow-up of 9.2 years, 20 680 patients (0.38) were diagnosed with AS and 6440 (0.12) patients with AR. Systolic BP (SBP) was continuously related to the risk of AS and AR with no evidence of a nadir down to 115 mmHg. Each 20 mmHg increment in SBP was associated with a 41 higher risk of AS (hazard ratio 1.41, 95 confidence interval 1.38-1.45) and a 38 higher risk of AR (1.38, 1.31-1.45). Associations were stronger in younger patients but with no strong evidence for interaction by gender or body mass index. Each 10 mmHg increment in diastolic BP was associated with a 24 higher risk of AS (1.24, 1.19-1.29) but not AR (1.04, 0.97-1.11). Each 15 mmHg increment in pulse pressure was associated with a 46 greater risk of AS (1.46, 1.42-1.50) and a 53 higher risk of AR (1.53, 1.45-1.62). Conclusion Long-term exposure to elevated BP across its whole spectrum was associated with increased risk of AS and AR. The possible causal nature of the observed associations warrants further investigation. © The Author(s) 2018. Published by Oxford University Press on behalf of the European Society of Cardiology.

Item Type: Article
Keywords: Aortic regurgitation; Aortic stenosis; Aortic valve disease; Blood pressure; Cohort study
Page Range: pp. 3596-3603
Journal or Publication Title: European Heart Journal
Journal Index: ISI, Pubmed, Scopus
Volume: 39
Number: 39
Identification Number: 10.1093/eurheartj/ehy486
Depositing User: دکتر محبوبه عبداللهی
URI: http://eprints.thums.ac.ir/id/eprint/713

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