Mitral valve prolapse and regurgitation.

The study by Wilcken and Hickey' in Circulation and the accompanying editorial comment by Devereux2 indicated that mitral valve prolapse (MVP) leads to severe mitral regurgitation (MR) much more frequently in men than in women. Both studies seemed to attribute the sex difference to higher blood pressure in men than women, as suggested by Roberts.3 However, Roberts' conclusion that the number of persons with both MVP and systemic hypertension in the United States was substantial was recently challenged by Holgado and Prakash,4 who found MVP in only one of 133 patients (0.75%) with hypertension. Therefore, the reason that significant MR occurs more frequently in elderly male patients with MVP whereas MVP per se is more frequent in younger women remains an enigma. Despite many advances made in recent years in epidemiologic,5 diagnostic,6 and prognostic7 studies of MVP, much more research work needs to be done. Tsung 0. Cheng, MD Professor of Medicine The George Washington University Washington, DC 20037 References