Non-specific aorto-arteritis in Singapore with special reference to hypertension

Aorto-arteritis has recently emerged as a distinct disease entity with involvement of aorta and its major branches by a non-specific inflammation of unknown etiology. Though the distribution of this disease is worldwide, it is more prevalent in Japan, India, and South-east Asia. This paper describes a series of 48 cases seen in Singapore and emphasizes the protean nature of this disease. Though modes of clinical presentation were many, hypertension appeared to be the commonest as it occurred in 33 patients, giving an incidence of 69 per cent. This incidence was much higher than the 48 per cent reported among Europeans and 42 per cent reported among South Africans. It would therefore appear that hypertension was a far more common manifestation of aorto-arteritis among Asians. The commonest cause of hypertension in aorto-arteritis in this series was renovascular, with renal artery stenosis or occlusion occurring in 27 cases (85 per cent). The frequency of involvement of the renal artery is much greater than the 34 per cent reported by the Japanese. Therefore renovascular hypertension should be regarded as a predominant feature of aorto-arteritis in Singapore.