Prevalence of proximal ascending aorta and target organ damage in hypertensive patients: the multicentric ARGO-SIIA project (Aortic RemodellinG in hypertensiOn of the Italian Society of Hypertension)

Aim: The aim of this study was to assess the prevalence of
ascending aortic dilatation and to evaluate the possible
association between proximal aorta dilatation and
structural or functional markers of cardiac organ damage
in hypertensive patients.
Background: Dilatation of the sinus of valsalva (SoV) is a
common finding in clinical practice and it is associated
with an increased cardiovascular risk in hypertensive
patients: less is known about the dilatation prevalence of
the subsequent portion, the proper ascending aorta and its
relationship with cardiovascular organ damage.
Methods: This multicentric study included 582
hypertensive and 104 normotensive control individuals.
All individuals underwent clinical evaluation and twodimensional transthoracic echocardiography focused on
the evaluation of the aorta. Aortic diameters at three levels
were measured: SoV, sinotubular junction and ascending
aorta.
Results: The prevalence of ascending aorta dilatation was
13%. Patients with ascending aorta dilatation were on
average 10 years older than hypertensive patients without
aortic dilatation and control individuals.
Left ventricular mass was significantly increased
(P < 0.0001) in patients with ascending aorta dilatation
with (113.29 3 g/m2
) or without (109.16 3 g/m2
) SoV
dilatation compared with patients with isolated SoV
dilatation (98.80 21.8 g/m2
) or normal aorta
(96.04 26.5 g/m2
), with left ventricular hypertrophy (LVH)
being twice as common in this group compared with the
latter (60 vs. 28%, P < 0.0001).
Conclusion: Prevalence of ascending aorta dilatation in
hypertensive patients reaches 13%. Hypertensive
individuals with enlarged ascending aorta showed
significantly increased left ventricular mass, a well known
sign of hypertension related cardiac damage and could
thus represent a subset of hypertensive patients at an
increased cardiovascular risk.