Key result
Above-target blood pressure persists in ~54% of thoracic aortic aneurysm patients despite specialized care.
Why the study?
International guidelines recommend tight blood pressure control in thoracic aortic aneurysm to prevent increased growth, dissection, or rupture, but blood pressure control in patients referred to a tertiary aortic program required evaluation.
More than half of patients with thoracic aortic aneurysm referred to a tertiary center have inadequately controlled blood pressure, highlighting a significant gap in guideline-directed risk factor management.
May indicate persistent BP control gaps in referred TAA; leaves open whether targeted interventions improve outcomes.
Background: International guidelines recommend tight blood pressure (BP) control in patients with thoracic aortic aneurysm (TAA). Hypertension in TAA patients has been associated with an increased rate of aneurysm growth and also with aortic dissection or aortic rupture. We aimed to study BP control in TAA patients referred by a primary or cardiology provider to a tertiary aortic management program. Methods: This retrospective study analyzed 3525 consecutive patients with confirmed TAA diagnosis referred by a primary-care or cardiology provider for management at the Lankenau Aortic Surgical Program between January 2021 and December 2024. Blood pressure was registered using an appropriately sized cuff and a calibrated automated sphygmomanometer. Clinical and demographic data were compared between patients with different stages of hypertension, based on the 2023 ESH guidelines. Results: The overall rate of above-target BP in TAA patients was 54.2% (1911/3525). From the hypertension group, Stage 1 (BP > 140/90) accounted for 53.4% (1020/1911) of patients, with Stage 2 (BP > 160/100) accounting for 12.6% (241/1911) and Stage 3 (BP > 180/110) for 1.8% (35/1911). Among associations of hypertension with demographic data by zip code, no significant differences were observed between groups with respect to race, median household income, or house value. There was a tendency of lower BP in patients from residential areas with higher rates of college graduates compared to those without college education (OR: 0.995; p = 0.059). Conclusions: Hypertension remains both highly prevalent and inadequately controlled in patients with TAA, even within specialized care environments. These findings emphasize the need for a more comprehensive approach to risk factor management to improve outcomes in this high-risk population.
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Ramlawi et al. (2026) studied this question. 54.2% of thoracic aortic aneurysm patients had above-target blood pressure despite specialized care, with stage 1 hypertension comprising 53.4% of these cases.
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