Table 1.

Selected studies on the treatment of hypertension in aortic stenosis.

Trial, Author Year	Design	Sample Size	Medication or Class	Follow-Up	Results
Khot, U. et al., 2003 [82]	prospective	25	Nitroprussiate	24 h	Nitroprusside improves heart function in patients with decompensated heart failure due to severe left ventricular systolic dysfunction and severe aortic stenosis.
SCOPE-AS, Chockalingam et al., 2004 [55]	randomized double-blind	52	Enalapril 2.5 mg bis in die titrated up to 10 mg bis in die vs. placebo	12 weeks	NYHA class, Borg index and 6 min walking test improvement.
O’Brien et al., 2005 [71]	retrospective	123	ACE-inhibitors	2.6 ± 1.8 years	Less calcification of the aorta on CT.
Ralph A H Stewart et al., 2008 [83]	randomized	65	Eplerenone 100 mg/die	19 months	In patients with moderate–severe aortic stenosis, eplerenone does not slow down the onset of ventricular dysfunction, does not reduce the mass of the left ventricle and does not reduce the progression to valve stenosis.
Nadir et al., 2011 [53]	retrospective	2117	RAAS blockers	4.2 years	Lower frequency of mortality and cardiovascular events.
Lindman BR et al., 2012 [87]	open-label	22	Sildenafil 40 mg or 80 mg		A single dose of Sildenafil is safe and well-tolerated in patients with symptomatic severe aortic stenosis. It also improves stroke volume and reduces pre- and postload.
Eleid MF et al., 2013 [30]	prospective	24	Nitroprussiate		Nitroprusside is safe in patients with low-flow LG AS.
Capoulade et al., 2013 [63]	retrospective	338	RAAS blockers	6.2 ± 2.4 years	Angiotensin II receptor blocker I, but not ACE-I, was associated with slower progression of AS and lower mortality.
Dalsgaard et al., 2014 [67]	randomized	44	Trandolapril up to 2 mg/die	3 days	Blood pressure, peripheral resistance and left ventricular end-systolic volume were significantly reduced.
Goel et al., 2014 [56]	retrospective	1752	RAAS blockers	5.8 years	Better long-term survival after aortic valve replacement.
Bang et al., 2014 [68]	prospective	1873	RAAS blockers	4.3 ± 0.9 years	Slowed progression of the ventricular mass.
RIAS, 2015 [69]	randomized double-blind	100	Ramipril 10 mg vs. placebo	1 year	Improved systolic function, decreased left ventricular mass and slight reduction in left ventricular mass with Ramipril.
Helske-Suishko et al., 2015 [70]	randomized	51	Candesartan	5 months	No improvement.
Yamamoto et al., 2015 [64]	prospective	359	No intervention	3 years	Angiotensin II receptor blockers were associated with a smaller decrease in the indexed valve area in patients with AS jet velocity <2 m/s.
Claveau et al., 2015 [81]	retrospective	195	Nitrates		When nitroglycerin was used for acute pulmonary edema in patients with moderate and severe aortic stenosis, the risk of clinically detected hypotension as an adverse event was comparable to patients without aortic stenosis.
Bang et al., 2017 [79]	prospective	1873	Beta-blockers	4.3 ± 0.9 years	Lower mortality.
Magne et al., 2018 [57]	retrospective	508	RAAS blockers	4.8 ± 2.7 years	Better long-term survival after valve replacement.
Inohara et al., 2018 [58]	retrospective	21312	RAAS blockers	1 year	Lower mortality and lower risk of rehospitalization 1 year after TAVI.
Ochiai et al., 2018 [59]	retrospective	1215	RAAS blockers	1.1 years	Lower mortality and greater reduction in ventricular mass 1 year after TAVI.
SIOVAC 2018 [88]	randomized	200	Sildenafil	6 months	Worst clinical outcome of patients treated with Sildenafil compared to placebo.
Rodriguez-Gabella et al., 2019 [60]	retrospective	2785	RAAS blockers	3 years	Reduced cardiovascular mortality at 1 and 3 years after TAVI.
Saeed et al., 2020 [89]	retrospective	314	Calcium channel blocker	2.9 ± 2.9 years	Sevenfold increased risk of all-cause mortality.