Can Aortic Regurgitation Cause High Blood Pressure

​Aortic regurgitation (sometimes referred to as aortic valve regurgitation) occurs when the aortic valve in your heart doesn’t close tightly.

This allows some of the blood that should be leaving the heart to leak back into it. In turn, this may stop your heart from pumping blood efficiently around your body, causing shortness of breath and fatigue.

It may develop quickly or take many years to become apparent, however, once it becomes severe it can cause a number of concerning complications and conditions.  

Let’s explore aortic regurgitation in more detail, including the causes, symptoms, and treatments available.



What Exactly Is Aortic Regurgitation? 

WHAT EXACTLY IS AORTIC REGURGITATION?

In your heart there are four chambers, each with a valve that opens to let blood flow out of the heart. These valves are known as the pulmonary valve, tricuspid valve, mitral valve, and aortic valve.

When they’re healthy, the valves, which have flaps (known as leaflets or cusps) open wide to allow blood to move freely around the body and heart. But then they’ll close tightly until the heart beats again.

In some cases, these valves don’t close or open properly, which disrupts the blood flow in the heart and can impair its ability to pump blood effectively around the rest of the body.

When this occurs in the aortic valve, this is known as aortic valve regurgitation.

The aortic valve is found between the left ventricle (the chamber in the bottom left-hand side of your heart) and the aorta (the main artery that goes to the rest of your body). So when this doesn’t close properly, blood is allowed to go back into the left ventricle, meaning it has to hold more blood. In turn, this can cause thickening or enlarging of the ventricle.

Initially, this works in the heart’s favor because the thickening gives it more force to pump blood, helping it maintain healthy blood flow. But over time, these changes start to weaken this part of the heart as well as the rest of the heart.

The problems that arise from this can be serious and even life-threatening.         



What Are the Symptoms of Aortic Regurgitation? 

WHAT ARE THE SYMPTOMS OF AORTIC REGURGITATION?

Aortic valve regurgitation may develop in the background for a long time without giving you any specific signs. However, when you do notice the symptoms, these may gradually become apparent or may come on suddenly.

These include:

  • Swelling in the ankles
  • Shortness of breath
  • Fatigue
  • Chest pain that gets worse when you exercise
  • Rapid pulse rate

If you do experience any of these symptoms or notice any changes that may be related to your heart, you should seek medical advice immediately.



What Causes Aortic Regurgitation?

Regurgitation can be caused by any condition that damages the heart’s valves. But there are some specific causes that may lead to aortic valve regurgitation:

  • Congenital heart valve disease: This occurs when you’re born with a condition that affects the cusps in the valves of your heart. For example, you may have fused cusps or only two cusps (compared to the three separate ones the aortic valve is supposed to have). Or you may have a single cusp or four cusps but the latter is very rare.
    Nevertheless, when these congenital defects arise, they put you at risk of suffering from aortic valve regurgitation in the future. Having a sibling or parent with fused cusps increases your risk but the problem can arise without a known family history of the condition.

  • Rheumatic fever: If strep throat isn’t treated correctly, it may develop into rheumatic fever. Although much less common than it used to be, it can cause damage to the aortic valve. In older adults, this is the most common cause of serious cases of aortic valve regurgitation.

  • Age-related heart changes: Over time, the aortic valve may stiffen due to a build of calcium deposits. If this happens, it may make the valve narrow so it can’t close properly.

  • Endocarditis: A type of heart infection, this tends to originate elsewhere in the body. It causes bacteria or germs to travel to the heart through the blood, causing damage (an infection) once they get there. Your valves are vulnerable to this infection.

  • Aortic valve stenosis: This occurs when, due to stiffness or thickness, your aortic valve is unable to open fully. It can also make it difficult for the valve to close properly which causes the regurgitation.

  • Trauma: If the area near to your aortic valve, the aorta, is damaged through a tear or injury to the chest, this can cause blood to flow backward through the valve.
  • Other diseases: Rarer conditions may lead to regurgitation due to enlargement of the aortic valve and aorta. This includes the connective tissue disease, Marfan syndrome. Equally, certain autoimmune conditions can lead to regurgitation, e.g. lupus.


What Are the Risks Factors?  

There are a number of factors that may contribute toward the development of aortic valve regurgitation, including:

  • Old age
  • History of infections that have the ability to damage the heart
  • Congenital heart disease and other conditions present at birth
  • Certain valve conditions like aortic valve stenosis
  • Other conditions that may have an effect on the heart, e.g. Marfan syndrome
  • High blood pressure


Who’s More Likely to Develop Aortic Valve Regurgitation?

You have a far greater chance of developing this condition if you have a congenital heart defect from birth or you have had rheumatic fever.

As you get older your risk increases due to the stretching of the leaflets that occurs naturally over time.

If you have high blood pressure this also increases your likelihood of valve regurgitation because this can damage the part of your heart where the aortic valve meets the aorta.


Can Aortic Regurgitation Cause High Blood Pressure, Then? 

The two are most definitely linked.

However, as we’ve already seen, high blood pressure causes aortic valve regurgitation, not the other way around.

In fact, doctors have recently discovered a connection between high blood pressure and another common heart problem – mitral regurgitation (valve regurgitation in a different part of the heart). The study found that patients who had high blood pressure during their early years were at far greater risk of developing this condition (which also makes the heart less able to pump blood effectively around the body).

Therefore, they concluded that this incredibly disabling and common valve disorder isn’t always “inevitable” through aging, rather, it could be prevented by managing blood pressure – something that’s also the case with aortic valve regurgitation.



The Complications That May Arise

THE COMPLICATIONS THAT MAY ARISE

If aortic valve regurgitation isn’t treated or monitored correctly, the most serious complication is heart failure. This occurs when blood isn’t pumped around your body properly because your heart muscle has become too weak.

It may also increase your risk of developing endocarditis – the heart infection we mentioned earlier.



Preventing High Blood Pressure and Aortic Valve Regurgitation

As with any heart condition, it’s crucial you see your doctor so they can monitor the condition and perhaps catch it in its early stages when it’s far more treatable.

Should you be diagnosed with a leaking or tight valve, you’ll probably be monitored on a regular basis using echocardiograms. These will ensure the valve isn’t allowed to get worse.

Furthermore, as high blood pressure is a primary cause of aortic valve regurgitation, keeping this in check should be a top priority.



Tips for Controlling High Blood Pressure 

Successfully controlling your blood pressure might reduce, delay, or completely eradicate your need for medication. You can do this by:

  1. Watching your waistline, getting rid of any extra pounds you may be carrying around
  2. Exercising regularly – up to 150 minutes per week
  3. Enjoying a healthy diet
  4. Reducing how much salt is in your diet
  5. Limiting your alcohol intake
  6. Quitting smoking
  7. Cutting back on caffeine
  8. Reducing your stress levels
  9. Monitoring your blood pressure at home and with your doctor
  10. Getting support from family and friends to make these changes to your health

All of the above doesn’t just relate to high blood pressure, as they are also good steps to take to prevent aortic valve regurgitation and generally maintain a healthy heart.



Treating the Condition 

If your regurgitation is deemed mild, you might not require any treatment. Instead, you’ll be monitored regularly to ensure the problem doesn’t become severe.

Should you have high blood pressure, the aforementioned lifestyle changes and perhaps medication will be used to keep it in check.

Medication may also be recommended if you’re at risk of developing blood clots (i.e. if it’s likely blood could pool in your heart). As these can cause strokes or heart attacks, medicating them is essential.

In serious cases, the best option may be to replace the aortic valve completely. While this used to involve open-heart surgery, there are now innovative ways to do this by using catheters that are placed in your arteries.



The Outlook for Patients with Aortic Regurgitation 

While there isn’t a guaranteed way to prevent the onset of aortic valve regurgitation, there are many ways you can reduce your risk and keep your heart healthy.

Equally, if you develop strep throat, be sure to get it treated way before it develops into rheumatic fever. And take high blood pressure seriously, making sure your blood pressure is always within the healthy range.



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