Association between aortic stenosis and hypertension.
OBJECTIVE
Hypertension causes increased shear stress across the aortic valve. Shear stress across endothelial cells in vitro induces inflammation, which has been demonstrated on stenosed valve leaflets in vivo. In theory, longstanding hypertension could result in aortic stenosis. The study aim was to identify a possible clinical association between these two conditions.


METHODS
Data relating to patients with a primary or secondary discharge diagnosis of hypertension or aortic stenosis in the Republic of Ireland were obtained from the Hospital In-Patient Enquiry National File for 1995 to 1999 inclusive. Proportions were compared using chi-squared testing.


RESULTS
A total of 3.39 million discharges occurred during this period. Hypertension was the primary or secondary diagnosis in 6.2%, and aortic stenosis in 0.33%. Both conditions were present in 0.07%. Hypertension was present in 21.0% of those with aortic stenosis, and aortic stenosis in 1.1% of those with hypertension. Hypertension was associated with aortic stenosis with an odds ratio of 4.0 (95% confidence interval 3.9 to 4.2, p = 0.0001).


CONCLUSIONS
Aortic stenosis and hypertension were significantly associated in patients discharged from hospital. If hypertension is shown to be contributing to aortic valve disease then, potentially, better blood pressure control might prevent the progression of stenosis.
D001024:Aortic Valve Stenosis / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D001794:Blood Pressure / Q000502:physiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D007494:Ireland / Q000453:epidemiology; D008297:Male; D016017:Odds Ratio; D010351:Patient Discharge / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors