Objectives of this study were to evaluate the prevalence of proximal ascending aortic dilatation (pAAD) in essential hypertensives and the association between pAA ectasia, arterial stiffness and cardiac organ damage.

Background: There are few data in literature concerning pAAD in arterial hypertension. It is not known whether pAAD may be related to increased cardiac organ damage and what the relation with central hemodynamics and arterial stiffness would be in essential hypertension.

Methods: We measured in 345 treated and untreated essential hypertensives (54.3±11 years) clinic blood pressures, central hemodynamics through radial tonometry and proximal aortic diameters using transthoracic echocardiography. BSA-normalized diameter cut off for aortic ectasia definition was 2,1 cm/m2.

Results: Overall prevalence of pAA dilatation was 17% in our population. We observed a slightly increase of central systolic (129.81±15.4 vs. 125.02±14.7 p 0.02) and pulse pressure (45.02±10.4 vs. 42±9.54; p 0.02) in patients with pAAD, whereas peripheral haemodynamic parameters were similar. Pulse wave velocity was significantly greater (9.26±2.33 vs. 7.70±1.69 p<0.0001), as well as the augmentation index (25.86±10.2 vs. 19.41±9.52; p<0.0001) in patients with pAAD, and this difference maintained after correction for age. Left ventricular hypertrophy was thrice as frequent (32.8% vs. 13.4% p<0.0001) compared to hypertensive patients without pAA dilatation.

Conclusions: This study shows a high prevalence (17%) of ascending aorta dilatation in patients affected by essential hypertension, without further complications. Dilatation of the ascending aorta is associated to increased cardiac organ damage and arterial stiffness.