Elevated Systolic Blood Pressure Linked to Increase in Valvular Heart Disease

MedicalResearch.com Interview with:

Prof-Kazem Rahimi

Prof. Rahimi

Dr Kazem Rahimi
Deputy Director of the George Centre for Healthcare Innovation
James Martin Senior Fellow in Essential Healthcare
Honorary Consultant Cardiologist at the John Radcliffe Hospital
Deputy Director of the George Institute for Global Health

MedicalResearch.com: What is the background for this study?

Response: In the last century, we have witnessed a dramatic change in the spectrum of valvular heart disease and the prevalence of this condition has been rapidly increasing, due to population ageing, with poor patient outcomes and high healthcare costs associated with the only effective treatment available, which is valve repair or replacement. However, modifiable risk factors for valvular heart disease remain largely unknown, which limits prevention and treatment. We used a state-of-the-art, gene-based method called Mendelian randomization to determine the causality of the association between systolic blood pressure and risk of valvular heart diseases. 

MedicalResearch.com: What are the main findings? 

Response: This study showed that elevated systolic blood pressure is causally associated with an increased risk of aortic stenosis, mitral regurgitation and aortic regurgitation. In summary, each 20-mmHg higher systolic blood pressure was found to increase the odds of valvular heart diseases by nearly three-fold. The Mendelian randomization study is less prone to confounding and reverse causation and thus suggests that blood pressure-lowering treatment may be an effective strategy for prevention of valvular heart diseases.

MedicalResearch.com: What should readers take away from your report? 

Response: Clinical practice guidelines currently make little reference to preventative strategies for major valvular heart diseases, but this study highlights that high blood pressure should be considered a major risk factor, much as it is for heart attacks, stroke and other cardiovascular conditions. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Experimental research is warranted to clarify the underlying mechanisms for the observed association between elevated systolic blood pressure and valvular heart diseases. 

MedicalResearch.com: Is there anything else you would like to add? 

Response: Mendelian randomization study takes advantage of the naturally occurring randomized exposure of individuals to genetic variants that are highly associated with lifetime systolic blood pressure. It is similar to random allocation of treatment in clinical trials and it can thus overcome the problems of reverse causation and confounding that are typical of non-randomized observational studies.

Citation:

Nazarzadeh M, Pinho-Gomes A, Smith Byrne K, et al. Systolic Blood Pressure and Risk of Valvular Heart DiseaseA Mendelian Randomization StudyJAMA Cardiol. Published online July 10, 2019. doi:10.1001/jamacardio.2019.2202

Jul 12, 2019 @ 12:07 pm

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