title: Aortic size index enlargement is associated with central hemodynamics in essential hypertension.
abstract: The aim of this study was to evaluate the association between brachial and central blood pressure (bBP and cBP) levels and aortic root dilatation (ARD) in essential hypertensive patients. A total of 190 untreated and treated essential hypertensive patients (mean age, 55 ± 11 years) were considered for this analysis. We measured pulsatile hemodynamics and the proximal aortic diameter directly using tonometry, ultrasound imaging (echocardiography) and Doppler. Ninety-one hypertensive patients had an ARD (defined as aortic size index (ASi)>2 cm/m(2)). Central hemodynamic variables were significantly associated with ASi. Patients with increased ASi were significantly older (60 ± 10 vs. 50 ± 11 years, P < 0.0001) and had higher levels of the augmentation index (AIx; 28 ± 10 vs. 21 ± 10 P < 0.0001), augmentation pressure (AP; 13 ± 6 vs. 8 ± 5 mm Hg, P < 0.0001), and central pulse pressure (cPP; 44 ± 10 vs. 39 ± 8 mm Hg, P<0.0001) compared with patients with normal ASi. In a logistic regression analysis, the AIx was the only significant predictor of ASi. In hypertensive patients, the AIx and cBP were associated with ARD, whereas the bBP was not. Patients with an increased ASi may lose part of the elastic properties of the aorta, demonstrating a strict correlation between ASi and central hemodynamic indexes, in particular, the cPP and AIx.
authors.affiliation: Department of Medicine and Experimental Oncology, Division of Internal Medicine, Hypertension Unit, University Hospital S Giovanni Battista, Torino, Italy. alberto.milan@unito.it
authors.forename: Alberto
authors.initials: A
authors.lastname: Milan
authors.forename: Francesco
authors.initials: F
authors.lastname: Tosello
authors.forename: Mimma
authors.initials: M
authors.lastname: Caserta
authors.forename: Diego
authors.initials: D
authors.lastname: Naso
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Puglisi
authors.forename: Corrado
authors.initials: C
authors.lastname: Magnino
authors.forename: Chiara
authors.initials: C
authors.lastname: Comoglio
authors.forename: Franco
authors.initials: F
authors.lastname: Rabbia
authors.forename: Paolo
authors.initials: P
authors.lastname: Mulatero
authors.forename: Franco
authors.initials: F
authors.lastname: Veglio
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001011:Aorta / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001794:Blood Pressure; D002339:Carotid Arteries / Q000503:physiopathology; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016015:Logistic Models; D008875:Middle Aged; D011673:Pulsatile Flow; D014463:Ultrasonography