This Article Full Text Full Text (PDF) All Versions of this Article: 52/3/473    most recent HYPERTENSIONAHA.108.114157v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Ingelsson, E. Articles by Vasan, R. S. Search for Related Content PubMed PubMed Citation Articles by Ingelsson, E. Articles by Vasan, R. S. Related Collections Clinical Studies Echocardiography Epidemiology

(Hypertension. 2008;52:473.)
© 2008 American Heart Association, Inc.

Original Articles

Aortic Root Diameter and Longitudinal Blood Pressure Tracking

Erik Ingelsson; Michael J. Pencina; Daniel Levy; Jayashri Aragam; Gary F. Mitchell; Emelia J. Benjamin; Ramachandran S. Vasan

From the Framingham Study (E.I., M.J.P., D.L., J.A., E.J.B., R.S.V.) and Evans Memorial Department of Medicine and Whitaker Cardiovascular Institute (E.J.B., R.S.V.), Boston University School of Medicine, Framingham, Mass; Department of Medical Epidemiology and Biostatistics (E.I.), Karolinska Institute, Stockholm, Sweden; Department of Mathematics (M.J.P.), Boston University, Mass; Center for Population Studies (D.L.), National Heart, Lung, and Blood Institute, Bethesda, Md; Veterans’ Administration Hospital (J.A.), West Roxbury, Mass; Cardiovascular Engineering, Inc (G.F.M.), Holliston, Mass; and Epidemiology Department (E.J.B.), Boston University School of Public Health, Mass.

Correspondence to Ramachandran S. Vasan, Framingham Heart Study, 73 Mount Wayte Ave, Suite 2, Framingham, MA 01702-5803. E-mail vasan{at}bu.edu

Proximal aortic diameter, including aortic root (AoR) diameter, has been inversely related to pulse pressure in cross-sectional studies. So, investigators have hypothesized that a smaller AoR diameter may increase the risk of developing hypertension. Prospective studies are lacking to test this hypothesis. We measured AoR diameter in 3195 Framingham Study participants (mean age: 49 years; 57% women; 8460 person-examinations) free from hypertension and previous cardiovascular disease who underwent routine echocardiography. We related AoR to hypertension incidence and blood pressure (BP) progression (increment of 1 category, as defined by the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure). On follow-up (median: 4 years), 1267 individuals (15%; 661 women) developed hypertension, and 2978 participants experienced BP progression (35%; 1588 women). In logistic regression models adjusted for age, sex, and height, AoR was positively associated with hypertension incidence (odds ratio: 1.15; 95% CI: 1.08 to 1.23) and BP progression (odds ratio: 1.09; 95% CI: 1.04 to 1.14) on follow-up. However, adjustment for other factors known to influence BP tracking (baseline systolic and diastolic BP, smoking, diabetes, and weight) rendered these relations statistically nonsignificant (odds ratio: 1.03; 95% CI: 0.96 to 1.11 for hypertension incidence; odds ratio: 1.03; 95% CI: 0.97 to 1.08 for BP progression). In our large community-based sample of nonhypertensive individuals, AoR diameter was not associated with hypertension incidence or BP progression prospectively after adjustment for potential confounders. Our prospective study does not support the notion that a smaller AoR predisposes to hypertension.

Key Words: blood pressure • aorta • hypertension