Abstract 14973: Correlates of Aortic Root Dilatation among Young Adults Over a 20 Year Period: The Coronary Artery Risk Development in Young Adults (CARDIA) Study
Aortic dilatation and stiffening at mid- to advanced adulthood predict future cardiovascular events. However, recent work has demonstrated important aortic biomechanical changes early in the lifespan of humans. We aim to evaluate the determinants of aortic dilatation over 20 years in young adults enrolled in the CARDIA study.
Methods:3062 generally healthy young adults with echocardiography at CARDIA Year-5 (Y5) (1990-1991) and Year-25 (Y25) were included. Individuals with significant valvular heart disease were excluded (n=18). Aortic Root Diameter (ARD) was measured by M-mode echocardiography at Y5 and Y25. Univariate analyses and multivariate analyses were used to evaluate the effect of age, gender, race, weight, height, diabetes, smoking, cholesterol, blood pressure and treatment for high blood pressure (HBP) on ARD at Year 25, adjusting for ARD at Y5. Model 1 included baseline and changes in systolic (SBP) and diastolic (DBP) blood pressure. Model 2 included baseline and changes in mean blood pressure (MBP) and pulse (PP) pressure.
Results: 3044 individuals were included, 56% female and 45% black. Mean age at Y5 was 30.6±3.6years. Mean ARD was 27.8±3.8mm and 30.7±4.2mm at Y5 and Y25, respectively. In the univariate analyses, ARD at Y25 was greater in men (33.3±3.7mm vs 28.7±3.4mm, p<0.001) and in white (30.9±4.3 vs 30.5±4.1, p=0.005). In the multivariate analyses (Table), gender, race, height, weight, changes in weight, baseline SBP and DBP, baseline active smoking and changes in DBP were positively associated with ARD at Y25. In Model 2, ARD at Y25 was positively correlated with MBP and change in MBP and negatively correlated with PP and change in PP.
Conclusions: Aortic root enlargement in early adulthood is related to gender, race, height, weight, smoking and blood pressure. In early adulthood, smoking cessation, weight and blood pressure control may be particularly important in preventing aortic root dilatation and adverse biomechanical aortic alterations.
- © 2012 by American Heart Association, Inc.