Disease of aging

Aortic Stenosis

Last updated 2026-07-02· Last reviewed 2026-07-02· 1 min read

Reviewed by the Ultimate Longevity Bible editorial team. Educational reference — not medical advice. See disclaimer.

Pathophysiology

Calcific AS is driven by:

Mechanical stress at the valve leaflets.
Endothelial injury and lipid deposition.
Local inflammation and senescent-cell accumulation.
Osteogenic differentiation of valve interstitial cells with subsequent calcification.

Presentation

Angina, syncope, and heart failure. Systolic ejection murmur radiating to the carotids. Progression from asymptomatic to symptomatic marks a crucial decision point.

Diagnosis

Echocardiography (valve area, mean gradient, peak velocity).
CT for TAVR planning.

Management

Symptomatic severe AS: valve replacement (SAVR or TAVR).
TAVR: initially for high-risk patients, now approved across low-, intermediate-, and high-risk categories.
Medical therapy: no drug slows AS progression; statins tested and failed (SEAS trial).

Longevity relevance

Represents mechanical aging + calcification + senescence intersection at a critical organ. Anti-calcification therapeutics targeting valve interstitial cell osteogenesis are an active research area.