From the Guidelines
Blood Pressure Guidelines for Aortic Root Dilation
The target blood pressure for patients with aortic root dilation should be less than 130/80 mmHg.
- This guideline is based on the most recent recommendations from the American College of Cardiology (ACC) and the American Heart Association (AHA) 1.
- The evidence suggests that aggressive blood pressure lowering can reduce vascular-related adverse events and all-cause mortality in patients with clinical cardiovascular disease, including those with aortic root dilation.
- The use of antihypertensive medication, such as beta blockers and agents that alter the renin-angiotensin system, is recommended to achieve this blood pressure goal 1.
- In some cases, a more intensive systolic blood pressure goal of less than 120 mmHg may be beneficial, particularly in patients without diabetes, as shown in the SPRINT trial 1.
- However, it is essential to individualize blood pressure targets based on patient characteristics, such as the presence of diabetes or chronic renal disease, and to monitor for potential adverse effects of aggressive blood pressure lowering.
- Lifestyle modifications, including diet, weight reduction, moderation of alcohol consumption, and aerobic exercise, are also recommended as standard approaches to treat hypertension, but pharmacological therapy is usually required for patients with aortic root dilation 1.
From the Research
Blood Pressure Guidelines for Aortic Root Dilation
The relationship between blood pressure and aortic root dilation is complex, and several studies have investigated this topic.
- A study published in the Journal of Hypertension in 2006 found that aortic root dilatation was present in 8.5% of men and 3.1% of women with essential hypertension, and was associated with higher diastolic blood pressure values 2.
- Another study published in the Journal of Hypertension in 2022 found that the incidence of aortic root dilatation in a general middle-aged population was not substantially related to baseline office and ambulatory blood pressure or their changes over time 3.
- A study published in the European Journal of Preventive Cardiology in 2021 found that patients with incident aortic root dilatation were more likely to have higher diastolic blood pressure and stroke volume index at baseline, and higher average value of diastolic blood pressure during follow-up 4.
Predictors of Aortic Root Dilation
Several factors have been identified as predictors of aortic root dilation, including:
- Left ventricular hypertrophy, which was found to be a predictor of aortic root dilatation in several studies 2, 3, 4.
- Age, which was found to be related to aortic root diameter in women but not in men 5.
- Obesity, which was found to be associated with incident aortic root dilatation 4.
- Diabetes and metabolic syndrome, which were found to be associated with aortic root dilatation in a study published in the Journal of Hypertension in 2006 2.
Clinical Implications
Aortic root dilatation has been found to be a useful marker of high cardiovascular risk related to target organ damage 2.