Hypertension frequently coexists in patients with aortic valve (AV) disease 1,2 and is associated with an additional load on the left ventricle (LV), increased LV hypertrophy, impaired LV function and worse clinical outcomes 3, 4, 5, 6. There has been a misconception that antihypertensive treatment may have harmful effects in hypertensive patients with aortic stenosis (AS), but careful use of antihypertensive agents is beneficial and well tolerated even in patients with severe AS 7, 8, 9. Thus, hypertension should be treated in patients with AV disease, and antihypertensive therapy follows the guidelines on the management of hypertension for the general population 10. The 2017 American College of Cardiology/American Heart Association (ACC/AHA) guidelines for hypertension indicate values less than 130/80 mmHg as the optimal targets of blood pressure (BP) in all individuals 9, whereas the European Society of Cardiology/European Society of Hypertension (ESC/ESH) guidelines for hypertension recommend a systolic BP less than 140 mmHg but higher than 130 mmHg in elderly patients 7. Optimal BP levels in patients with AV disease are controversial because no randomized, controlled trials have been conducted for the management of hypertension in AV disease and there are no specific recommendations for a target BP in current guidelines for the management of valvular heart disease 3,11. In the SEAS trial (Simvastatin and Ezetimibe in Aortic Stenosis), a U-curve association was demonstrated for all-cause mortality and systolic BP, where a systolic BP in the range of 130–139 mmHg was associated with the best survival in a multivariate analysis 12. However, the survival hazard for SBP < 130 mmHg was not explained and low SBP might be a marker of an unmeasured variable affecting the prognosis of patients with mild to moderate AS 13. Randomized trials are encouraged to evaluate the effects of intensive BP management in AV disease, and we tried to investigate whether intensive BP control reduces LV hypertrophy in asymptomatic, hypertensive patients with AS or aortic regurgitation (AR) in a prospective, multicenter, randomized trial.