Hypertension and Valvular Heart Disease: An Overview of a Complex and Clinically Meaningful Relationship

The overlooked relationship between hypertension (HTN) and valvular heart disease (VHD) has been brought to wider attention by large-scale population studies and the latest guidelines. Approximately 45% of patients with VHD have been diagnosed with HTN. This association increases with age, but cannot be explained solely by the rising prevalence of both conditions. HTN promotes the onset or worsening of VHD by mechanically stressing the valves and by modified blood flow dynamics through increased filling pressures and afterload. It has been shown that a 20 mmHg rise in BP triples the risk of aortic valvular disease and mitral regurgitation. This review will address the impact of HTN on the occurrence and progression of valvular lesions, its effect on the prognosis of patients with VHD, and the available data on blood pressure management. As long as relatively well-documented data on aortic valve disease are available, studies are still needed to clarify target blood pressure values under therapy and the most appropriate drug classes for mitral regurgitation, especially in its primary forms.