Aortic Root Dilatation at Sinuses of Valsalva and Aortic Regurgitation in Hypertensive and Normotensive Subjects
Why the study?
Is suboptimally controlled hypertension associated with increased sinuses of Valsalva dilatation and aortic regurgitation compared to normotension or well-controlled hypertension?
Population
2,457 participants from the Hypertension Genetic Epidemiology Network study
Comparison
Suboptimally controlled hypertension vs Normotension or well-controlled hypertension
Design
Cross-sectional
Authors
Discussion
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Member takes
Implication
Suboptimal BP control may enlarge aortic roots without raising AR risk; leaves open causal effects of hypertension management on aortic remodeling.
Key Points
- To examine how sinuses of Valsalva dilatation and aortic regurgitation relate to hypertension status, blood pressure control, and echocardiographic measures in a population-based cohort.
- Evaluated clinical and echocardiographic data from 2,096 hypertensive and 361 normotensive participants in the Hypertension Genetic Epidemiology Network study.
- Calculated expected aortic root diameter from age and body surface area, defining aortic dilatation as a sinuses of Valsalva diameter exceeding the 97.5th percentile of predicted values.
- Aortic root dilatation was identified in 4.6% of the cohort, with significantly larger root dimensions in hypertensives with suboptimal blood pressure control than in normotensives or well-controlled hypertensives.
- Dilatation of the sinuses of Valsalva independently correlated with male sex, aortic valve fibrocalcification, wall motion abnormalities, increased left ventricular mass, and reduced systolic function, but not with diastolic blood pressure or hypertension history.
- Aortic regurgitation prevalence did not differ across hypertension categories, but its likelihood increased with larger aortic root diameter, advancing age, female sex, and aortic valve fibrocalcification.
Structured PICO
Is suboptimally controlled hypertension associated with increased sinuses of Valsalva dilatation and aortic regurgitation compared to normotension or well-controlled hypertension?
P
Population
2,457 participants (2,096 hypertensive and 361 normotensive) from the Hypertension Genetic Epidemiology Network study
I
Intervention
Suboptimally controlled hypertension
C
Comparator
Normotension or well-controlled hypertension
O
Outcome
Sinuses of Valsalva dilatation (aortic root diameter) and prevalence of aortic regurgitationsurrogate
Suboptimally controlled hypertension is associated with mildly larger sinuses of Valsalva diameter but does not increase the prevalence of aortic regurgitation compared to normotension or well-controlled hypertension.
Cite This Study
Palmieri et al. (2001) studied this question.