on July 28, 2008
Published online before print July 28, 2008, doi: 10.1161/HYPERTENSIONAHA.108.114157
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Submitted on March 30, 2008
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. * To whom correspondence should be addressed. E-mail: vasan{at}bu.edu.
Abstract—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
Revised on April 17, 2008
Aortic Root Diameter and Longitudinal Blood Pressure Tracking
Erik Ingelsson;
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