Established and emerging vascular risk factors and the development of aortic stenosis: an opportunity for prevention?

BACKGROUND: Aortic stenosis (AS) is the commonest valvular heart disease in the developed world. It is becoming increasingly accepted that the pathogenesis of AS and of its preceding abnormalities, aortic valve sclerosis (AVS) and aortic valve calcification (AVC), shares many characteristics with the atherosclerotic process. OBJECTIVE: To assess the contribution of established and emerging vascular risk factors in the development of AS and to evaluate the potential of pharmacological intervention to modify the natural history of AS. METHODS: We reviewed the epidemiological data that link AS and atherosclerosis and studies of vasculoprotective agents in patients with AS. RESULTS/CONCLUSIONS: AS, AVS and AVC share many common risk factors with atherosclerosis and are possible markers of preclinical vascular disease. Statins appear to delay the progression of AS. However, more studies are needed before introducing such pharmacologic treatment for AS. The future may point towards targeted prevention of AS.