What medications can slow the progression of aortic valve stenosis?

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Last updated: February 22, 2025 • View editorial policy

From the Guidelines

Currently, there are no medications proven to directly slow the progression of aortic stenosis, and the primary treatment for severe or symptomatic cases remains surgical intervention, typically aortic valve replacement. However, certain medications may be prescribed to manage symptoms and reduce cardiovascular risk factors associated with aortic stenosis:

  • Statins (e.g., atorvastatin, rosuvastatin): While initially thought to potentially slow progression, recent studies, such as the SEAS study 1, have not shown a significant effect on aortic stenosis progression. They are still often prescribed to manage cholesterol levels and reduce overall cardiovascular risk.
  • Antihypertensive medications: ACE inhibitors, ARBs, or beta-blockers may be used to control blood pressure, which can help reduce strain on the heart, as hypertension is a common comorbidity in patients with aortic stenosis and is associated with a higher rate of ischemic cardiovascular events and mortality 1.
  • Diuretics: These may be prescribed to reduce fluid retention and alleviate symptoms of heart failure associated with severe aortic stenosis.

It's essential to note that these medications primarily manage symptoms and comorbidities rather than directly addressing the progression of aortic stenosis itself. Regular monitoring of the condition through echocardiograms and clinical evaluations is crucial to determine the appropriate timing for surgical intervention. The lack of effective medical therapy for slowing aortic stenosis progression is due to the nature of the disease, which involves calcification and thickening of the aortic valve leaflets, a process not easily targeted by current pharmacological interventions, as highlighted in guidelines such as the 2020 ACC/AHA guideline for the management of patients with valvular heart disease 1 and the 2014 AHA/ACC guideline for the management of patients with valvular heart disease 2.

From the Research

Medications for Aortic Valve Stenosis

There are several medications that have been studied for their potential to slow the progression of aortic valve stenosis, including:

  • Statins: These medications have been shown to reduce the hemodynamic progression of aortic stenosis in some studies 3, 4, 5
  • Angiotensin-converting enzyme inhibitors (ACE-Is): These medications have been studied for their potential to slow the progression of aortic stenosis, but the results have been mixed 6, 4, 5
  • Proprotein Convertase Subtilisin/Kexin type 9 inhibitors (PCSK9-i): These medications have been hypothesized to decrease the progression of aortic stenosis and the requirement for valve implantation 7
  • Antisense oligonucleotides (ASO) and small interfering RNA (siRNA): These medications are currently being tested for their potential to reduce circulating lipoprotein(a) (Lp(a)) levels and slow the progression of aortic stenosis 7

Key Findings

Some key findings from the studies include:

  • Statins have been shown to reduce the hemodynamic progression of aortic stenosis in some studies, with an annualized increase in peak aortic jet velocity of 0.10+/-0.41 m x s(-1) x y(-1) in patients treated with statins, compared to 0.39+/-0.42 m x s(-1) x y(-1) in those who were not 5
  • ACE-Is have not been shown to significantly affect the hemodynamic progression of aortic stenosis in some studies, although they may have other benefits such as reducing mortality and admission for ischemic heart disease and congestive heart failure 4, 5
  • PCSK9-i and ASO/siRNA are still being studied for their potential to slow the progression of aortic stenosis, and more research is needed to fully understand their effects 7

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.