Revolutionizing Heart Health: The Link Between Hypertension, Valvular Heart Disease, and Transcatheter Aortic Valve Implantation

Hypertension, also known as consistently high blood pressure, occurs when the pressure of blood pushing against the walls of a person’s blood vessels is too high. 1? It is estimated that 1.28 billion adults aged 30-79 years worldwide have hypertension and that 46% of adults with hypertension are unaware that they have the condition. 2 While common, hypertension can put people at risk for other health problems if not treated. 1,?2 It has also been linked to heart diseases like valvular heart disease (VHD), which can cause severe damage to the heart. 1,?2

VHD occurs when any valve in the heart becomes damaged or diseased. 3,? A normal heart has four chambers and valves that open and close to regulate blood flow. ? When valves are damaged, they no longer open or close completely or can become narrowed and stiff. 3,? The heart cannot effectively pump blood throughout the body when this happens, which puts strain on the heart and can lead to heart failure and sudden cardiac arrest. 3,? Any valve in the heart can become diseased, but it is most common in the mitral and aortic valves. 1?

Research has conclusively found a link between hypertension and VHD, showing that long-term exposure to high systolic blood pressure (the pressure exerted when the heart contracts) significantly increases the chances of major VHD, including mitral regurgitation, aortic regurgitation, and aortic stenosis. ?,? This finding has considerable implications for clinical practice guidelines and health management, which tend to make little reference to preventative strategies for major VHD. ?,? Hypertension should be considered a significant risk factor for VHD, and the importance of controlling hypertension at the earliest opportunity should not be underestimated, especially considering hypertension usually develops over time and often does not present with symptoms. 1,2,?,? By checking their blood pressure regularly, people can manage their hypertension correctly to lower their risk of serious health problems and avoid developing diseases like VHD – which they can also address early should it occur. 1,?2

If a person’s VHD has not progressed too far, they can manage it with medications that help treat their symptoms. 3,? However, they may require surgery if damage to the valve is more severe and causes serious symptoms. 3,? The type of surgery and medical device used will depend on which valve is involved and what is causing the disease. 3,? More than 40 million people are living with either mitral or aortic valve disease worldwide, and transcatheter valve repair has emerged as an essential and expanded therapeutic option for these people, particularly for those who previously had no viable surgical options. ?,?

Over the past 20 years, innovations in transcatheter heart valve (THV) design have led to improved clinical outcomes and fewer complications.8 Notably, 30-day mortality rates have dropped from 7.2% to 2.5%, and stroke incidents from 2.75% to 2.3%. ? Moreover, 80% of patients report acceptable outcomes after one year. ? Technological advancements have optimized THV sizing and design, reducing complications like paravalvular leak and conduction disturbances. ? Lower profile delivery systems have also minimized vascular complications and bleeding. ? Transcatheter Aortic Valve Implantation (TAVI) technology has significantly evolved since its inception in 2002, now catering to a broader range of patients, including younger and lower-risk individuals. ? The number of TAVI procedures has consistently increased from 2011 to 2019, even surpassing surgical replacements. ? This ongoing evolution of TAVI technology continues to expand its reach, offering hope for more patients with valvular disease worldwide.

MicroPort? CardioFlow contributes to this therapeutic space with its TAVI solution, the VitaFlow LibertyTM Aortic Valve and Delivery System, which is a next-generation hybrid density stent with double-layer skirts and a bovine pericardial leaflet pre-treated with the Vital-X? technology that extracts phospholipids and cholesterol, stabilizing collagen formation. ? This feature prevents valve leaflets from calcification, minimizes structural valve deterioration, and prolongs valve durability. ? The retrievable delivery system has a motorized handle, allowing for fast, stable, and accurate release and retrieval. ? In addition, the capsule of the VitaFlow LibertyTM can be bent 360 degrees, providing superior flexibility to help minimize blood vessel damage and reduce the risk of complications. ? The motorized handle also gives operators better control over the retrieval and repositioning of the valve. ?

Transcatheter valve repair has become a standard therapy for patients due to its continuous technological evolution. MicroPort? is proud to be a part of this forward-thinking and innovative therapeutic landscape and continuously strives to incorporate features in our medical devices that mitigate procedural complications and improve patient outcomes, allowing patients everywhere to live better and longer lives.

Learn more about the VitaFlow LibertyTM Aortic Valve and Delivery System here: https://microport.com/healthcare-professional/cardiovascular/heart-valve

References:

1. Centers for Disease Control and Prevention. High Blood Pressure Symptoms [online]. 2021, May 18 [cited 2024, Mar 04]. Retrieved from: URL: https://www.cdc.gov/bloodpressure/about.htm#print .
2. Shimizu Y. Hypertension [online]. 2023, Mar 16 [cited 2024, Mar 04]. Retrieved from: URL: https://www.who.int/news-room/fact-sheets/detail/hypertension .
3. Rowden A. Valvular heart disease: Symptoms, causes, and risk factors [online]. 2022, Aug 31 [cited 2024, Mar 04]. Retrieved from: URL: https://www.medicalnewstoday.com/articles/valvular-heart-disease .
4. Centers for Disease Control and Prevention. Valvular Heart Disease [online]. 2019, Dec 09 [cited 2024, Mar 04]. Retrieved from: URL: https://www.cdc.gov/heartdisease/valvular_disease.htm#print .
5. National Institute for Health and Care Research. Research suggests high blood pressure is major cause of heart valve disease. 2019, Jul 10 [cited 2022, Mar 04]. Retrieved from: URL: https://oxfordbrc.nihr.ac.uk/research-suggests-high-blood-pressure-is-major-cause-of-heart-valve-disease/ .
6. Nazarzadeh M, Pinho-Gomes AC, Byrne KS, Canoy D, Raimondi F, Solares JR, et al. Systolic blood pressure and risk of valvular heart disease: a Mendelian randomization study. JAMA Cardiol 2019;4(8):788-95.
7. Davidson LJ,?Davidson CJ. Transcatheter Treatment of Valvular Heart Disease:?A Review.?JAMA?2021;325(24):2480–94.
8. Zaid S, Atkins M, Kleiman N, Reardon M, Tang G. What’s New with TAVR? An Update on Device Technology. Methodist DeBakey Cardiovasc J. 2023;19(3):4–14.
9. Santangelo G, Ielasi A, Pellicano M, Latib A, Tespili M, et al. An update on new generation transcatheter aortic valves and delivery systems. J Clin Med 2022;11(3):499.

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