About this trial
The aim of this study is to investigate the effect of strict blood pressure control versus conventional care in patients with asymptomatic moderate to severe aortic valve stenosis.
The study is a randomized (1:1), open label, controlled intervention trial.
Hypothesis:
1. Strict BP control for 12 months reduces the progression of LV remodelling compared to conventional treatment. 2. Strict BP control for 2 years reduces the increase in aortic valve calcification and LV remodelling compared to conventional treatment. 3. Strict BP reduction for up to 10 years reduces the need for aortic valve replacement and cardiovascular events compared to conventional care.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Aortic valve peak velocity (Vmax) of 3.0-5.0 m/s and/or aortic valve area (AVA) ≤ 1.2 cm2
Blood pressure: SBP >= 127 mmHg measured by BP-TRU
LVEF ≥ 50%
Age > 18 years
Disqualifiers
Symptoms due to AS
Symptomatic orthostatic hypotension and/or one minute standing SBP < 110 mmHg (16).
Suspicion of secondary hypertension
Participation in other randomized drug study (device studies accepted)
Trial design
Parallel
Treatments tested in this trial
Blood presssure reduction
Other interventionPatients will be uptitrated in antihypertensive treatment until the treatment target is achieved.
Treatment groups
Trial outcomes
Primary outcomes
Change in LV mass
LV mass as measured by cardiac MR
Change in aortic valve CT calcium volume and aortic peak gradient
Cardiac CT and Echocardiography
Clinical composite endpoint:
Major cardiovascular events including death from cardiovascular causes, aortic valve replacement, non-fatal myocardial infarction, hospitalization for unstable angina pectoris, heart failure, coronary artery bypass surgery, percutaneous coronary intervention, and haemorrhagic and non-haemorrhagic stroke, new onset atrial fibrillation.
Secondary outcomes
LV mass-cavity ratio.
Cardiac MR
LV myocardial fibrosis
Cardiac MR
Myocardial perfusion during rest and stress
Cardiac MR
Aortic peak and mean gradients
Echocardiography
Sponsors and contacts
Click on the lead sponsor to view all of their trials.
Henrik Wiggers
Lead sponsor
Aarhus University Hospital
Sponsor institution
Danish Heart Foundation
Collaborator