Radiological evaluation of the impact of chronic obstructive pulmonary disease on ascending aortic diameter in hypertensive patients

Aims: This study aims to radiologically evaluate the impact of chronic obstructive pulmonary disease (COPD) on the diameter of the ascending aorta (AsAo) in individuals diagnosed with hypertension and to explore the potential structural effects of COPD on the cardiovascular system. Methods: This retrospective cross-sectional study was conducted at Yozgat Bozok University Research and Training Hospital. Clinical and radiological data of 60 hypertensive individuals who underwent thoracic computed tomography (CT) between January 1, 2023, and June 1, 2025, were analyzed. Participants were divided into two groups based on the presence or absence of a COPD diagnosis. Ascending aorta and aortic arch (Arcus Ao) diameters were measured from CT images. Clinical variables, comorbidities, and lipid profiles were statistically evaluated. Results: The mean age of participants was significantly higher in the COPD group (73.8 ± 7.92 years) compared to the control group (67.93 ± 12.59 years) (p = 0.036). The mean AsAo diameter was 40.40 ± 4.90 mm in the COPD group and 36.01 ± 3.79 mm in the control group, revealing a statistically significant difference (p = 0.00028). No significant difference was found between the groups regarding Arcus Ao diameter (p = 0.103). Among lipid parameters, there were no significant differences in HDL, LDL, or total cholesterol levels; however, triglyceride levels approached statistical significance (p = 0.069). Conclusion: The findings suggest that COPD is not merely a respiratory condition but also a systemic disease with notable vascular implications. The significant increase in AsAo diameter in the COPD group may be attributed to chronic inflammation, endothelial dysfunction, and degeneration of elastic fibers associated with the disease. The absence of a significant difference in Arcus Ao diameter may be related to the anatomically stable structure of this segment. The higher comorbidity burden and older age observed in COPD patients further support the systemic nature of the disease.