Home BP Linked to Faster Dilation of Ascending Aortas

TOPLINE: 

Mildly to moderately dilated ascending aorta showed a generally slow progression over 6 years in this general population–based study. A higher 7-day home measured systolic blood pressure (BP) was the only factor associated with faster progression.

METHODOLOGY:

• Researchers followed 74 patients (mean age, 59 years; 22% women) with incidentally detected mild to moderately dilated ascending aortas, identified in a prospective general population–based study in Sweden.
• The patients had an ascending aortic diameter of at least 40 mm, identified via thoracic CT, coronary CT angiography, or transthoracic echocardiography.
• Follow-up transthoracic echocardiography was performed regularly to evaluate ascending aortic diameter progression over a mean period of 6.1 years.
• Patients with a rate of ascending aortic diameter progression exceeding the 90^th percentile were classified as having fast progression.
• Baseline assessments included office and home BP, coronary artery calcification, pulse wave velocity, and carotid plaques.

TAKEAWAY:

• At baseline, the aortic root and tubular ascending aorta diameters were 40 mm and 43 mm, respectively.
• The overall mean progression rate of the ascending aortic diameter was 0.4 mm/year.
• No progression in the aortic diameter was observed in 14% of patients, all of whom were men. Progression rates did not differ between sexes.
• A higher 7-day home systolic BP was the only factor significantly associated with faster progression of the ascending aortic diameter (regression coefficient B, 0.012; 95% CI, 0.001-0.023).

IN PRACTICE:

“Subjects with poor BP control may warrant more frequent monitoring, whereas less frequent control intervals seem reasonable for subjects with continuously slow progression rate or even stationary aortic diameters,” the authors wrote.

SOURCE:

This study was led by David Kylhammar, MD, PhD, Linkoping University, Linkoping, Sweden. It was published online on March 13, 2025, in Heart.

LIMITATIONS:

The small study population may have limited the statistical power to identify all associations between potential risk factors and the progression rate. The age range (50-65 years) of the study population was narrow. Additionally, the findings may not be generalisable to patients with genetic diseases that predispose them to thoracic aortic disease.

DISCLOSURES:

This study received support from the ALF agreement between the Swedish government and county councils, FORSS, and the Wallenberg Centre for Molecular Medicine in Linkoping. The authors declared having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.