Abstract 1654: Prevalence and Correlates of Aortic Root Dilatation in Normotensive and Hypertensive Adults: The Family Blood Pressure Program
Background: Aortic root dilatation (ARD) has been shown to predispose to aortic regurgitation (AR) and aortic dissection in clinical studies, but few population-based data exist on the prevalence ARD, its relation to hypertension and other risk factors or association with AR.
Methods: Echocardiograms were performed by a systematic protocol and read centrally to measure aortic diameter at the sinuses of Valsalva in 4,937 participants (1960 African-American, 1486 Hispanic, 1051 Japanese-American, 439 white) in the 2nd phase of the Family Blood Pressure Program (women 61%, hypertension 50%, diabetes 28%). ARD was determined by relating observed aortic diameter to that predicted for age and body size, and classified as mild (+2–3 SD above the predicted value), moderate (+3– 4 SDs) or severe (> +4 SDs), paralleling the ASE 2005 chamber quantification document.
Results: Overall, ARD was present in 308 (6.3%) participants: mild in 236 (4.8%), moderate in 40 (0.8%) and severe in 35 (0.8%). ARD was more common in men than women (12.4 vs. 2.4%, p<0.001) but observed/predicted aortic diameter was negatively associated age (r=−.06, p <0.001). In analyses adjusting for gender and age, ARD was not associated with hypertension, current blood pressure or diabetes (all p≥0.20). After adjustment for the above covariates, aortic diameter was minimally smaller in African-American than white participants, without difference in Hispanic or Japanese-Americans. Compared to participants with normal aortic diameter, mild, moderate and severe ARD was associated with increased prevalences of ≥mild AR (8, 26, 23 and 27%), ≥2+ AR (2, 10, 13 and 12%) and higher mean left ventricular mass index (37.1, 40.8, 42.5 and 45.6 g/m, all p<0.001) without difference in left ventricular ejection fraction (p=0.34).
Conclusions: In a large, diverse population-based sample, ARD is common, occurs disproportionately in men, and is not associated with hypertension. Greater ARD is associated with increased prevalences of AR and greater LV hypertrophy, which suggest that it may contribute to the population burden of cardiovascular events.