Mitral Valve Disease and Hypertension

The case records of 187 patients with mitral valve disease were studied to assess whether hypertension occurred more commonly than in the general population and if so what mechanism might be involved. Hypertension (diastolic pressure > 90 mm. Hg) was commoner in patients with mitral valve disease only in the presence of atrial fibrillation. Blood pressure values of those in sinus rhythm tended to be lower than those of the general population. Mitral valvotomy was found to reduce the incidence of hypertension and peripheral embolism even in those with atrial fibrillation. Post-mortem findings, although small in number, supported the evidence that renal infarction is associated with hypertension in those with mitral valve disease. We suggest that these findings provide further evidence that hypertension in mitral valve disease results from renal emboli following atrial fibrillation.