Hypertension in aortic stenosis does not interact with symptoms, functional capacity during ETT

Hypertension is associated with a high cardiovascular disease burden but does not appear to have any impact on symptoms or functional capacity during exercise treadmill test (ETT) in patients with aortic stenosis, results of a study have shown.

“Hypertension does not interfere with the clinical interpretation of exercise testing,” the authors said.

Of the 314 patients included, 229 (73 percent) with hypertension were older and were more likely to have diabetes, hypercholesterolaemia and coronary artery disease, larger left atrial diameter, higher left ventricular (LV) mass, and a higher proportion of LV hypertrophy than normotensive patients.

Hypertension and clinic systolic blood pressure (SBP) did not correlate with revealed symptoms in a univariate logistic regression analysis.

In a multivariate logistic regression analysis, lower peak SBP (odds ratio [OR], 1.02, 95 percent confidence interval [CI], 1.00–1.04; p=0.017) and rapid early rise in heart rate (OR, 15.03, 95 percent CI, 6.23–36.24; p<0.001) correlated with an increased risk of revealed symptoms, whereas the use of antihypertensive treatment led to a reduced risk of revealed symptoms (OR, 0.40, 95 percent CI, 0.18–0.89; p=0.025), independent of age, obesity, LV ejection fraction and aortic valve area.

In a linear regression analysis, the association between hypertension and lower metabolic equivalents (β, –0.06; p=0.311) was not maintained after adjusting for age, sex and body mass index.

This study included 314 patients (mean age, 65±12 years; 68 percent men) with moderate or severe asymptomatic aortic stenosis who underwent baseline echocardiography and ETT. Hypertension was defined as a history of elevated BP, part or current treatment with antihypertensive agents, or a BP at the baseline clinic visit >140/90 mm Hg.