Prognostic role of the ascending aorta dilatation in patients with arterial hypertension

Dario Leone, Lorenzo Airale, Sara Bernardi, Giulia Mingrone, Anna Astarita, Marco Cesareo, Luca Sabia, Eleonora Avenatti, Francesco Tosello, Giulia Bruno, Cinzia Catarinella, Veronica Venturelli, Carlo Giordana, Franco Veglio, Fabrizio Vallelonga, Alberto Milan

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Background:Ascending aorta (ASC) dilatation (AAD) is a common finding in arterial hypertension, affecting about 15% of hypertensive patients. AAD is associated with an increase in cardiac and vascular hypertension-related organ damage, but its prognostic role is unknown. The aim of the study was to evaluate the prognostic value of AAD as predictor of cardiovascular events in essential hypertensive patients.Methods:Recruited patients underwent two-dimensional transthoracic echocardiography from 2007 to 2013 and followed-up for cardiovascular events until November 2018 by phone call and hospital information system check. ASC diameter and AAD were defined using both absolute and scaled definitions. Four hundred and twenty-Three hypertensive patients were included in our study.Results:During a median follow-up of 7.4 years (interquartile range 5.6-9.1 years), 52 events were observed. After adjusting for age, sex and BSA, both ASC diameter and AAD definition, according to ARGO-SIIA project, resulted associated with a greater risk of cardiovascular event (both P < 0.010), even after adjusting for major confounders (both P < 0.010). Moreover, we observed that the assessment of ASC improves risk stratification compared with pulse wave velocity alone, and that in absence of AAD, sinus of valsalva dilatation lost any prognostic value (P = 0.262).Conclusions:ASC diameter and AAD are both associated with a greater risk of cardiovascular events. ASC should be assessed to optimize risk stratification in hypertensive patients and its dilatation may be considered as a surrogate for vascular organ damage.

Original languageEnglish (US)
Pages (from-to)1163-1169
Number of pages7
JournalJournal of Hypertension
Issue number6
StatePublished - Jun 1 2021


  • arterial hypertension
  • ascending aorta
  • ascending aorta dilatation
  • prognosis
  • transthoracic echocardiography

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine


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