A STUDY ABOUT ARTERIAL HYPERTENSION IN PATIENTS WITH AORTIC STENOSIS. (June 2018) - Naidin, O.
Abstract : Objective: Aortic stenosis (AS) and arterial hypertension (HT) are two common disorders affecting predominantly the ageing population, both negatively impacting morbidity and mortality, and their association should require more attention in terms of diagnosis and management. The aim of this study is to assess the distinctive features of AS concerning the clinical presentation and the paraclinical parameters between hypertensive and non-hypertensive patients. Design and method: The study was conducted by retrospective analysis of 144 cases of hospitalized patients, diagnosed with AS on a period of two years (01.01.2016–31.12.2017), with and without HT. We studied the differences between the two subgroups regarding the etiology, comorbidities, some echocardiographic parameters and laboratory findings. Results: Among the patients studied with AS, the average age of presentation was 77 years for both the hypertensive and non-hypertensive patients, but a significantly higher age was found for the degenerative AS comparing to the congenital AS (78.22 years vs 63.6 years, p < 0.05); 88.2% of the cases had systemic hypertension, most of them being treated by a combination of at least three anti-hypertensive drugs (83.3%). The leading cause of AS in both hypertensive and non-hypertensive patients was degenerative, accounting for 80.5% and 94.1 % of the cases respectively, followed by rheumatic fever and bicuspid aortic valve disease. In terms of echocardiographic measurements, we found that the HT had an effect of reduction of the aortic pressure gradients (43.11 mmHg vs 57 mmHg in the non-HT subgroup), which is consistent with the literature data, even if the threshold for statistical significance was not attained. The laboratory findings revealed that half of the hypertensive patients were found to have anemia, compared to 5.8% of the normotensive patients and almost half of the HT subgroup appeared to associate chronic kidney disease as opposed to only 23.5% in the non-HT patients. Conclusions: HT affects a high proportion of the patients admitted for AS, that is known to put population at risk for cardiovascular events, but the impact of their coexistence in terms of prognosis is yet to be clarified.