Prevalence of proximal ascending aorta and target organ damage in hypertensive patients

Milan, Alberto; Esposti, Daniela Degli; Salvetti, Massimo; Izzo, Raffaele; Moreo, Antonella; Pucci, Giacomo; Bruno, Giulia; Pareo, Ilenia; Parini, Angelo; Paini, Anna; Laurino, Flora Ilaria; Scocco, Paola; Sgariglia, Raffaella; Avenatti, Eleonora; Luca, Nicola De

doi:10.1097/hjh.0000000000001844

Cited by 18 publications

(11 citation statements)

References 18 publications

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“…Patients with AADa showed a higher rate of established cardiovascular risk factors, such as LVH, LAe and PWV more than 10 m/s, supporting previous evidences of a role of AAD in cardiovascular risk stratification [1,8]. In particular LVMi, arterial stiffness (in terms of PWV) and ASC dimension could be considered as three different anatomical expression of the same adaptive phenomenon.…”

Section: Discussionsupporting

confidence: 77%

“…Hypertension, such as ageing, are associated with an increase in arterial stiffness (in form of PWV) [17], affecting the summation between incident and reflexed pulse pressure waves at aortic root level [18,19]. This complex interplay leads to a mismatch between cardiac output and vascular impedance with consequent LVH and AAD, as recently suggested [8,20].…”

Section: Discussionmentioning

confidence: 97%

“…AAD was defined following three different methods: first, an ASC diameter more than 36 mm for female and 41 mm for male patients (AADa) [8]; second, an ASC diameter indexed to height 0.5 (ASCh 0.5 ) exceeding the 75th percentile of the population distribution; third, an ASC diameter indexed to BSA 0.4 (ASCi 0.5 ) exceeding the 75th percentile of the population distribution. In the last two methods the 75th percentile has been arbitrarily chosen as a threshold.…”

Section: Echocardiographymentioning

confidence: 99%

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Prognostic role of the ascending aorta dilatation in patients with arterial hypertension

Leone¹,

Airale²,

Bernardi³

et al. 2021

Journal of Hypertension

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Background: Ascending aorta (ASC) dilatation (AAD) is a common finding in arterial hypertension, affecting about 15% of hypertensive patients. AAD is associated with an increase in cardiac and vascular hypertension-related organ damage, but its prognostic role is unknown. The aim of the study was to evaluate the prognostic value of AAD as predictor of cardiovascular events in essential hypertensive patients.Methods: Recruited patients underwent two-dimensional transthoracic echocardiography from 2007 to 2013 and followed-up for cardiovascular events until November 2018 by phone call and hospital information system check. ASC diameter and AAD were defined using both absolute and scaled definitions. Four hundred and twenty-three hypertensive patients were included in our study.Results: During a median follow-up of 7.4 years (interquartile range 5.6-9.1 years), 52 events were observed. After adjusting for age, sex and BSA, both ASC diameter and AAD definition, according to ARGO-SIIA project, resulted associated with a greater risk of cardiovascular event (both P < 0.010), even after adjusting for major confounders (both P < 0.010). Moreover, we observed that the assessment of ASC improves risk stratification compared with pulse wave velocity alone, and that in absence of AAD, sinus of valsalva dilatation lost any prognostic value (P ¼ 0.262).Conclusions: ASC diameter and AAD are both associated with a greater risk of cardiovascular events. ASC should be assessed to optimize risk stratification in hypertensive patients and its dilatation may be considered as a surrogate for vascular organ damage.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 97%

Section: Echocardiographymentioning

confidence: 99%

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Prognostic role of the ascending aorta dilatation in patients with arterial hypertension

Leone¹,

Airale²,

Bernardi³

et al. 2021

Journal of Hypertension

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“…The prevalence of proximal aortic dilatation in hypertensive population varies from study to study owing to the differences in enrolled subjects (especially age), definition of aortic dilatation, and imaging methods. The prevalence ranged from 6.1 to 19% [3,8,32,33]. A meta-analysis including 10 791 hypertensive patients showed that the overall prevalence of echocardiographic aortic root dilation (ARD) was 9.1%, with a marked difference between men and women (12.7 versus 4.5%, P < 0.001) [3].…”

Section: Prevalence Of Proximal Aorta Dilatation In Hypertensionmentioning

confidence: 99%

Proximal aorta dilatation in hypertension

Zuo,

Liu,

Liu

et al. 2023

Journal of Hypertension

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Dilation of the proximal aorta is a common clinical manifestation in hypertensive patients. Although it is straightforward to link hypertension with proximal aortic dilation, previous studies on their interrelation have yielded controversial results. Cross-sectional design, methodology of blood pressure assessment, confounding factors like medications, and inconsistent reference values may lead to the paradoxical conclusions. Recently, advances have been made in the exploration of determinants and clinical value of proximal aortic dilatation. Thus, we reviewed these findings and summarized that aortic dilatation may be the consequence of hemodynamic and nonhemodynamic co-factors’ combined action. Moreover, proximal aortic dilatation tends to be a predictor for aortic aneurysm dissection or rupture, hypertensive target organ damage as well as cardiovascular events. The present review contributes to a comprehensive understanding of the pathological process of proximal aortic dilatation in hypertension.

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“…[3] Central blood pressure (cBP) is superior to bBP. [4] Central hemodynamics like cardiac output (CO) adds significantly to the details about the ultimate heart pumping. Arterial stiffness, similarly, is a gold standard in hypertension and measured in forms of pulse-wave velocity and augmentation index.…”

Section: Introductionmentioning

confidence: 99%

Central hemodynamics and arterial stiffness by oscillometric pulse-wave analysis in treated Gujarati euglycemic hypertensives: A case-control study

Solanki

Mehta

Panjwani

et al. 2019

J Family Med Prim Care

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Introduction: Hypertension is the most prevalent noncommunicable disorder, studied in terms of brachial blood pressure. Direct parameters like central hemodynamics and arterial stiffness, though superior, are not studied much. The same can be studied by pulse-wave analysis (PWA) and we did that in euglycemic treated hypertensives. Materials and Methods: A case-control study was conducted in 258 treated euglycemic hypertensives and 258 matched controls. Oscillometric PWA was accomplished by Mobil-O-Graph (IEM, Germany). Parameters were further analyzed for the effect of gender, physical activity, body mass index (BMI) (cutoff 23), blood pressure control, and duration (cutoff 5 years). Multiple linear regressions were used to find significant predictors. P < 0.05 was taken as statistically significant. Results: Cases had significantly higher brachial arterial parameters (blood pressure, heart rate, rate pressure product), arterial stiffness (augmentation pressure, augmentation index, pulse-wave velocity, total arterial stiffness, pulse pressure amplification), and central hemodynamics (central blood pressure, cardiac output, stroke work) compared to age, gender, and BMI-matched controls. In the case group, female gender, BMI ≥ 23, and uncontrolled blood pressure were significant factors affecting results. Heart rate and pulse pressure were major predictors of study parameters. Central pressure parameters were not predicted significantly by corresponding brachial pressure parameters. Conclusion: PWA revealed the adverse profile of arterial stiffness and central hemodynamics in treated Gujarati hypertensives, associated with female gender, BMI, and blood pressure control, predicted mainly by heart rate and pulse pressure, independent of brachial blood pressure. It indicates both potential and further study of these parameters.

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Prevalence of proximal ascending aorta and target organ damage in hypertensive patients

Cited by 18 publications

References 18 publications

Prognostic role of the ascending aorta dilatation in patients with arterial hypertension

Prognostic role of the ascending aorta dilatation in patients with arterial hypertension

Proximal aorta dilatation in hypertension

Central hemodynamics and arterial stiffness by oscillometric pulse-wave analysis in treated Gujarati euglycemic hypertensives: A case-control study

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