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Arterial hypertension and diastolic blood pressure associate with aortic stenosis
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.ORCID iD: 0000-0002-3002-4877
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.ORCID iD: 0000-0003-2475-7131
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2019 (English)In: Scandinavian Cardiovascular Journal, ISSN 1401-7431, E-ISSN 1651-2006, Vol. 53, no 2, p. 91-97Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: Due to age-related differences in aortic valve structure, it is likely that the pathophysiology of aortic stenosis (AS) and associated risk factors differ between age groups. Here we prospectively studied the influence of traditional cardiovascular risk factors on AS development requiring surgery among patients without concomitant coronary artery disease (CAD) and stratified for age.

DESIGN: This study included 322 patients, who had prior to surgery for AS participated in population-based surveys, and 131 of them had no visible CAD upon preoperative coronary angiogram. For each case, we selected four referents matched for age, gender, and geographic area. To identify predictors for surgery, we used multivariable conditional logistic regression with a model including arterial hypertension (or measured blood pressure and antihypertensive medication), cholesterol levels, diabetes, body mass index (BMI), and smoking.

RESULTS: In patients without CAD, future surgery for AS was associated with arterial hypertension and elevated levels of diastolic blood pressure in patients younger than 60 years at surgery (odds ratio [95% confidence interval]), (3.40 [1.45-7.93] and 1.60 [1.09-2.37], respectively), and with only impaired fasting glucose tolerance in patients 60 years or older at surgery (3.22 [1.19-8.76]).

CONCLUSION: Arterial hypertension and elevated diastolic blood pressure are associated with a risk for AS requiring surgery in subjects below 60 years of age. Strict blood pressure control in this group is strongly advocated to avoid other cardiovascular diseases correlated to hypertension. If hypertension and elevated diastolic blood pressure are risk factors for developing AS requiring surgery need further investigations. Notably, elevated fasting glucose levels were related to AS requiring surgery in older adults without concomitant CAD.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2019. Vol. 53, no 2, p. 91-97
Keywords [en]
Aortic stenosis, bicuspid aortic valve, diabetes, hypertension, valve disease surgery
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:umu:diva-159471DOI: 10.1080/14017431.2019.1605094ISI: 000469026200007PubMedID: 31109205OAI: oai:DiVA.org:umu-159471DiVA, id: diva2:1318669
Funder
Swedish Heart Lung Foundation, 20140799Swedish Heart Lung Foundation, 20120631Swedish Heart Lung Foundation, 20100635Västerbotten County Council, VLL-548791Available from: 2019-05-28 Created: 2019-05-28 Last updated: 2019-06-17Bibliographically approved

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Ljungberg, JohanJohansson, BengtEngström, Karl GunnarNorberg, MargaretaBergdahl, Ingvar ASöderberg, Stefan
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CardiologySurgeryDepartment of Epidemiology and Global HealthDepartment of Biobank Research
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