The chest radiographA useful investigation in the evaluation of hypertensive patients

BACKGROUND: The assessment of target organ damage is important in the evaluation of a hypertensive patient as it provides information on the severity of the hypertension and the cardiovascular risk assessment. The aim of our study was to determine the usefulness of the chest radiograph in the assessment of target organ damage in hypertensive patients. METHODS: Unselected patients attending an academic hypertension clinic were studied. The cardiothoracic ratio and the aortic knob width were measured and compared to other markers of target organ damage. The aortic width was measured in age- and sex-matched controls. RESULTS: Seventy-two hypertensive and 77 age- and sex-matched normotensives were evaluated. There was a highly significant difference the aortic knob width between the normotensive and hypertensive patients (3.28 cm v 3.69 cm, P <.0001). The aortic knob width was significantly correlated with age in normotensive and hypertensive patients, systolic and diastolic blood pressure (BP), and all markers of target organ damage except the electrocardiogram (ECG) voltage. The cardiothoracic ratio was also significantly correlated with age and other markers of target organ damage, but not clinic BP. Multiple regression analysis revealed that only the cardiothoracic ratio (r = 0.34, P <.02) and the ECG voltage (r = 0.58, P <.00005) were independently correlated with left ventricular mass. CONCLUSIONS: The chest radiograph provides important predictive information of associated target organ damage in hypertensive patients.