Normalization of ascending aorta dimension for body size influences pathophysiologic correlation in hypertensive patients: the Campania Salute Network

Aim: In the present study, we assessed correlates and their consistency of AscAo measurement in treated hypertensive patients. Methods: 1634 patients ≥ 18 years old with available AscAo ultrasound were included. AscAo was measured at end-diastole with leading edge to leading edge method, perpendicular to the long-axis of the aorta in parasternal long-axis view at its maximal identifiable dimension. Correlations of AscAo and AscAo normalized for height (AscAo/HT) or body surface area (AscAo/BSA) with demographics and metabolic profile were explored. Multivariable regression was also used to identify potential confounders influencing univariate correlations. Sensitivity analysis was performed using CV outcome. Results: Correlations with age, eGFR, systolic BP and HR were similar among the 3 aortic measures. Women exhibited smaller AscAo, but larger AscAo/BSA than men with AscAo/HT offsetting the sex difference. Obesity and diabetes were associated with greater AscAo and AscAo/HT but with smaller AscAo/BSA (all p < 0.001). In multivariable regression model all aortic measure confirmed the sign of their relations with sex and metabolic profile independently of age, BP and HR. In Kaplan Mayer analysis only dilated AscAo and AscAo/HT were significantly associated with increased risk of CV events (both p < 0.008). Conclusions: Among patients with long standing controlled systemic hypertension, magnitude of aortic remodelling is influenced by the type of the measure adopted, with physiological consistency only for AscAo and AscAo/HT, but not for AscAo/BSA.