Aortic root dilatation in essential hypertension: Prevalence according to new reference values

Background: Aortic root dilatation (ARD) and arterial hypertension represent two important risk factors for aortic dissection: prevalence of observed ARD is increasing-up to 12% in the latest available reports. A recently published work tested on a good number of healthy individuals new reference ranges for aortic root dimensions, suggesting new reference values with corrections for age, gender, height (pHeight) or body surface area (pBSA). AIM:: The aim of the study was to evaluate the prevalence of ARD in hypertensive patients using various criteria. Methods: A total of 1076 untreated and treated essential hypertensive patients (mean age, 52.5 ± 2 years) were considered for this analysis. We measured proximal aortic diameters using ultrasound imaging (echocardiography). ARD was defined in three ways. First, when the observed aortic diameter was larger than that predicted for age, sex, and BSA (pBSA), second when larger than predicted by height (pHeight), and third when the aortic diameter to BSA ratio (ASi) was at least 2.1 cm/m. Results: A total of 237 patients (22% of the study population) showed at least one among the three different criteria defining aortic dilatation. Prevalence of ARD, considering singularly each one of the criteria, varied between 12.8% (pBSA) and 16.9% (pHeight). Conclusion: Our study demonstrated a prevalence of ARD higher than previously reported. Our data suggest, therefore, the necessity of a correct choice of the diagnostic criterion that has to be applied in the single patient for definition of ARD. In particular, using the criterion pHeight in obese patients, we may avoid underdiagnosis of this condition.