PMID- 29180457
OWN - NLM
STAT- MEDLINE
DCOM- 20180716
LR  - 20181113
IS  - 2047-9980 (Electronic)
IS  - 2047-9980 (Linking)
VI  - 6
IP  - 12
DP  - 2017 Nov 27
TI  - Antihypertensive Treatment With beta-Blockade in Patients With Asymptomatic Aortic 
      Stenosis and Association With Cardiovascular Events.
LID - 10.1161/JAHA.117.006709 [doi]
LID - e006709
AB  - BACKGROUND: Patients with aortic stenosis (AS) often have concomitant 
      hypertension. Antihypertensive treatment with a beta-blocker (Bbl) is frequently 
      avoided because of fear of depression of left ventricular function. However, it 
      remains unclear whether antihypertensive treatment with a Bbl is associated with 
      increased risk of cardiovascular events in patients with asymptomatic mild to 
      moderate AS. METHODS AND RESULTS: We did a post hoc analysis of 1873 asymptomatic 
      patients with mild to moderate AS and preserved left ventricular ejection 
      fraction in the SEAS (Simvastatin and Ezetimibe in Aortic Stenosis) study. 
      Propensity-matched Cox regression and competing risk analyses were used to assess 
      risk ratios for all-cause mortality, sudden cardiac death, and cardiovascular 
      death. A total of 932 (50%) patients received Bbl at baseline. During a median 
      follow-up of 4.3+/-0.9 years, 545 underwent aortic valve replacement, and 205 died; 
      of those, 101 were cardiovascular deaths, including 40 sudden cardiovascular 
      deaths. In adjusted analyses, Bbl use was associated with lower risk of all-cause 
      mortality (hazard ratio 0.5, 95% confidence interval 0.3-0.7, P<0.001), 
      cardiovascular death (hazard ratio 0.4, 95% confidence interval 0.2-0.7, 
      P<0.001), and sudden cardiac death (hazard ratio 0.2, 95% confidence interval 
      0.1-0.6, P=0.004). This was confirmed in competing risk analyses (all P<0.004). 
      No interaction was detected with AS severity (all P>0.1). CONCLUSIONS: In post 
      hoc analyses Bbl therapy did not increase the risk of all-cause mortality, sudden 
      cardiac death, or cardiovascular death in patients with asymptomatic mild to 
      moderate AS. A prospective study may be warranted to determine if Bbl therapy is 
      in fact beneficial. CLINICAL TRIAL REGISTRATION: URL: 
      http://www.clinicaltrials.gov. Unique identifier: NCT00092677.
CI  - (c) 2017 The Authors. Published on behalf of the American Heart Association, Inc., 
      by Wiley.
FAU - Bang, Casper N
AU  - Bang CN
AD  - Department of Cardiology, Zealand University Hospital Roskilde, Roskilde, Denmark 
      casperbang@hotmail.com.
AD  - Department of Medicine, Weill Cornell Medicine, New York, NY.
FAU - Greve, Anders M
AU  - Greve AM
AD  - Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark.
FAU - Rossebo, Anne B
AU  - Rossebo AB
AD  - Department of Cardiology, Oslo University Hospital Ulleval, Oslo, Norway.
FAU - Ray, Simon
AU  - Ray S
AD  - Department of Cardiology, Manchester Academic Health Sciences Centre, Manchester, 
      United Kingdom.
FAU - Egstrup, Kenneth
AU  - Egstrup K
AD  - Department of Cardiology, Odense University Hospital, Svendborg, Denmark.
FAU - Boman, Kurt
AU  - Boman K
AD  - Institution of Public Health and Clinical Medicine, Medicine Skelleftea, Umea 
      University, Skelleftea, Sweden.
FAU - Nienaber, Christoph
AU  - Nienaber C
AD  - Department of Cardiology, University Hospital, Rostock, Germany.
FAU - Okin, Peter M
AU  - Okin PM
AD  - Department of Medicine, Weill Cornell Medicine, New York, NY.
FAU - Devereux, Richard B
AU  - Devereux RB
AD  - Department of Medicine, Weill Cornell Medicine, New York, NY.
FAU - Wachtell, Kristian
AU  - Wachtell K
AD  - Department of Medicine, Weill Cornell Medicine, New York, NY.
AD  - Department of Cardiology, Oslo University Hospital, Oslo, Norway.
LA  - eng
SI  - ClinicalTrials.gov/NCT00092677
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
DEP - 20171127
PL  - England
TA  - J Am Heart Assoc
JT  - Journal of the American Heart Association
JID - 101580524
RN  - 0 (Adrenergic beta-1 Receptor Antagonists)
RN  - 0 (Anticholesteremic Agents)
RN  - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors)
RN  - AGG2FN16EV (Simvastatin)
RN  - EOR26LQQ24 (Ezetimibe)
SB  - IM
MH  - Adrenergic beta-1 Receptor Antagonists/*administration & dosage
MH  - Aged
MH  - Aged, 80 and over
MH  - Anticholesteremic Agents/administration & dosage
MH  - Aortic Valve Stenosis/*complications/mortality/physiopathology
MH  - Asymptomatic Diseases
MH  - Blood Pressure/drug effects/*physiology
MH  - Cause of Death/trends
MH  - Dose-Response Relationship, Drug
MH  - Double-Blind Method
MH  - Drug Therapy, Combination
MH  - Echocardiography, Doppler/methods
MH  - Ezetimibe/*administration & dosage
MH  - Female
MH  - Heart Ventricles/diagnostic imaging/*physiopathology
MH  - Humans
MH  - Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage
MH  - Hypertension/*drug therapy/epidemiology/etiology
MH  - Male
MH  - Middle Aged
MH  - Morbidity/trends
MH  - Propensity Score
MH  - Simvastatin/*administration & dosage
MH  - Survival Rate/trends
MH  - United States/epidemiology
PMC - PMC5779004
OTO - NOTNLM
OT  - aortic valve stenosis
OT  - arrhythmia (heart rhythm disorders)
OT  - atrial fibrillation
OT  - high blood pressure
OT  - hypertension
OT  - beta-blocker
EDAT- 2017/11/29 06:00
MHDA- 2018/07/17 06:00
PMCR- 2017/12/01
CRDT- 2017/11/29 06:00
PHST- 2017/11/29 06:00 [entrez]
PHST- 2017/11/29 06:00 [pubmed]
PHST- 2018/07/17 06:00 [medline]
PHST- 2017/12/01 00:00 [pmc-release]
AID - JAHA.117.006709 [pii]
AID - JAH32668 [pii]
AID - 10.1161/JAHA.117.006709 [doi]
PST - epublish
SO  - J Am Heart Assoc. 2017 Nov 27;6(12):e006709. doi: 10.1161/JAHA.117.006709.