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Abdominal aortic calcium and geometry in patients with essential hypertension
Damian Craiem1, Federico Guilenea1, Jean-Batiste de Freminville2
1Instituto de Medecina Traslacional, Trasplante y Bioingenieria (IMeTTyB), Universidad Favaloro-CONICET, CP1078 Buenos Aires, Argentina.
Insights
In patients with essential hypertension, abdominal aorta dilation is linked to diastolic blood pressure. Abdominal aorta calcium (AAC) is associated with smoking and resistant hypertension, particularly in the supra-renal region.
Area of Science:
- Cardiovascular Research
- Hypertension Studies
- Medical Imaging Analysis
Background:
- Abdominal aorta calcium (AAC) burden and dilatation correlate with increased mortality risk.
- Understanding determinants of AAC and aorta size is crucial for managing hypertension complications.
Purpose of the Study:
- To investigate the factors influencing abdominal aorta calcium (AAC) and abdominal aorta size in patients diagnosed with essential hypertension.
Main Methods:
- Recruited 293 patients with essential hypertension undergoing non-enhanced abdominal CT scans.
- Utilized a semi-automatic system to quantify aortic size (diameter, length, volume) and AAC (Agatston score).
- Employed uni- and multivariable analyses to identify determinants of aortic size and AAC.
Main Results:
- Abdominal aorta diameter positively correlated with diastolic blood pressure after adjustments.
- Smoking was the sole significant predictor of calcified abdominal aorta.
- AAC score increased with smoking history, statin use, number of antihypertensive drugs, larger aorta size, and higher systolic blood pressure.
- Resistant hypertension was associated with increased AAC in the supra-renal abdominal aorta.
Conclusions:
- Abdominal aorta dilation in essential hypertension is associated with diastolic blood pressure.
- Smoking history and resistant hypertension are linked to AAC, especially in the supra-renal portion of the abdominal aorta.
Purpose:
Abdominal aorta calcium (AAC) burden and dilatation are associated with an increased risk of mortality. The purpose of this study was to investigate determinants of AAC and abdominal aorta size in patients with essential hypertension.
Materials And Methods:
Patients with uncomplicated essential hypertension who had undergone non-enhanced abdominal CT to rule out secondary hypertension in addition to biological test were recruited between 2010 and 2018. A semi-automatic system was designed to estimate the aortic size (diameter, length, volume) and quantify the AAC from mesenteric artery to bifurcation using the Agatston score. Determinants of aortic size and those related to AAC were searched for using uni- and multivariables analyses.
Results:
Among 293 randomly selected patients with hypertension (age 52 ± 11 [SD] years) included, 23% had resistant hypertension. Mean abdominal aorta diameter was 20.1 ± 2.1 (SD) mm. Eight (3%) patients had abdominal aorta aneurysm ≥ 30 mm and 58 (20%) had dilated abdominal aorta ≥ 27 mm. Median AAC score was 38 and calcifications were detected in the infra- and supra-renal abdominal aortic portions in 59% and 26% of the patients, respectively. After adjustment for age, male sex and body surface area, abdominal aorta diameter was positively associated with diastolic blood pressure (P = 0.0019). Smoking was the single variable associated with calcified abdominal aorta (P < 0.001) after adjustment for cofactors. In patients with calcifications of abdominal aorta, the score increased with smoking history (P < 0.001), statins treatment (P < 0.01), greater number of anti-hypertensive drugs (P < 0.01), larger abdominal aorta (P < 0.05) and greater systolic blood pressure (P < 0.05). Patients with resistant hypertension had more AAC in the supra-renal abdominal aorta portion than those without resistant hypertension (P < 0.01).
Conclusion:
In patients with essential hypertension, abdominal aorta dilation is related with diastolic blood pressure while AAC is associated with smoking history and resistant hypertension when located to the supra-renal abdominal aorta portion.
