While we propose that wood smoke exposure may contribute to valve disease development, it is crucial to recognize that the typical onset of degenerative aortic valve disease occurs at an advanced age, together with accumulation of traditional atherosclerotic risk factors such as hypertension, abnormal lipid profile, and related biomarkers such as Endothelin 1 (ET-1) [18,19]. This evidence concerns the gene EDN1 and hypertensive disorder.