Correlation between coronary artery calcium score and aorta diameter in population with long-standing hypertension using noncontrast CT scan

Background: Early detection of aortic aneurysms is challenging in hypertensive patients due to the high risk of life-threatening ruptures. Limited studies on the relationship between coronary artery calcium and aortic diameter are present. This study evaluated the correlation between coronary artery calcium score (CACS) and maximal thoracic and abdominal aortic diameters in hypertensive patients, using a noncontrast CT scan. Material and methods: We prospectively enrolled 180 hypertensive patients older than 45 who had no aortic aneurysm or heart disease. We split the study population into five classes according to CACS (0, 1–10, 10–100, 100–400, and > 400). We calculated coronary artery calcium and maximal diameters of the ascending thoracic aorta (ATAMAX), descending thoracic aorta (DTAMAX), and abdominal aorta (AAMAX) using native computed tomography imaging. Results: Coronary artery calcium score was high in patients with high abdominal aorta diameter but not with the high diameters of the thoracic aorta. The cut-off point of the abdominal aorta’s maximum diameter was 34 mm, so AAMAX > 34 mm is predictive of a diagnosis of CACS category five (CACS > 400). There were no differences in ascending and descending thoracic aorta measurements between patients with a coronary artery calcium score of more than 400 (category 5) and the rest. Conclusion: Screening for an abdominal aortic aneurysm is essential in hypertensive patients as the coronary artery calcium score is associated significantly with increased abdominal aorta diameter. However, the necessity for thoracic aortic aneurysm screening is not apparent in these patients as no significant association is found between CACS and thoracic aorta diameter.