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Aortic size index enlargement is associated with central hemodynamics in essential hypertension

Alberto Milan1, Francesco Tosello, Mimma Caserta

  • 1Department of Medicine and Experimental Oncology, Division of Internal Medicine, Hypertension Unit, University Hospital S Giovanni Battista, Torino, Italy. alberto.milan@unito.it

Hypertension Research : Official Journal of the Japanese Society of Hypertension
|October 1, 2010
PubMed

Insights

Central blood pressure and augmentation index, not brachial blood pressure, are linked to aortic root dilatation in hypertensive patients. This suggests central hemodynamics are key indicators of aortic changes.

Area of Science:

  • Cardiovascular Medicine
  • Hypertension Research
  • Vascular Biology

Background:

  • Essential hypertension is a major risk factor for cardiovascular complications.
  • Aortic root dilatation (ARD) is a significant indicator of cardiovascular risk.
  • The relationship between blood pressure measurements and ARD requires further elucidation.

Purpose of the Study:

  • To investigate the association between brachial blood pressure (bBP) and central blood pressure (cBP) with aortic root dilatation (ARD) in essential hypertensive patients.
  • To identify specific hemodynamic parameters that predict ARD in this population.

Main Methods:

  • Analysis of 190 untreated and treated essential hypertensive patients.
  • Measurement of pulsatile hemodynamics and proximal aortic diameter using tonometry, echocardiography, and Doppler.
  • Definition of ARD based on aortic size index (ASi > 2 cm/m²).

Main Results:

  • Ninety-one patients (48%) presented with ARD.
  • Patients with ARD were older and exhibited higher augmentation index (AIx), augmentation pressure (AP), and central pulse pressure (cPP).
  • Logistic regression identified AIx as the sole significant predictor of ASi; cBP and AIx were associated with ARD, but bBP was not.

Conclusions:

  • Central hemodynamic parameters, particularly AIx and cPP, are significantly associated with aortic root dilatation in hypertensive patients.
  • Brachial blood pressure is not a significant predictor of ARD, highlighting the importance of central hemodynamics.
  • Increased ASi may reflect a loss of aortic elastic properties, correlating strongly with central hemodynamic indices.

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