ABSTRACT
Although early reports suggested that hypertension predisposed to aortic root enlargement and consequent aortic regurgitation, more recent pathological and M-mode echocardiographic studies have not found an association between hypertension and aortic root enlargement when age is considered. Objective: The aim of this study is to asses the effect of hypertension on aortic root size and to estimate the prevalence of aortic regurgitation. Methods: Measurement of two-dimensional echocardiographic diameters of the aortic root at four locations and compared findings with resting blood pressures and measures of body BMI in 110 normotensive and 110 hypertensive men and women matched for age and sex. Colour and continuous wave Doppler study are used to diagnose and assess severity of aortic regurgitation. Results:Aortic diameters at the annulus [2.40 plus or minus 0.29] versus 2.33 plus or minus 0.24 cm, P=06] and sinuses [3.45 plus or minus 0.43 versus 3.35 plus or minus 0.35, p=08] were marginally higher, whereas diameters at the supra-aortic ridge [2.93 plus or minus 0.39 versus 2.73 plus or minus 0.33 cm, P less than 01] were significally increased in hypertensive subjects. Aortic diameters increased with increasing quartiles of diastolic and systolic pressures, particularly at the supra-aortic ridge and ascending aorta. In multivariate analyses, blood pressure remained an independent determinant of distal aortic diameters after body size and age were considered. Aortic regurgitation was seen in 6 normotensive and 8 hypertensive subjects and did not differ in severity. Conclusion: Hypertension is associated with a slight increase in aortic root size, most notably of the supra-aortic ridge and proximal ascending aorta. Although dilation at the commissural attachment might be expected to predispose to an increase in aortic regurgitation, we did not detect such a difference in this population of, asymptomatic hypertensive individuals