Effect of hypertensive response to exercise on aortic diameters

Abstract

Abstract Background The diameters of the sinus of Valsalva as well as the ascending aorta are related to age, sex, and body size. There are conflicting data regarding the effect of arterial hypertension and a scarcity of data on the effect of a hypertensive response to exercise on aortic diameters. Purpose In this prospective cohort study, we aimed to evaluate the relationship between the growth rates of the sinus of Valsalva and ascending aorta in individuals with a hypertensive response to exercise. Methods Our analysis included follow-up data of 649 patients from our cohort study. Participants with known connective tissue disease were excluded. Sinus of Valsalva and ascending aorta diameters were measured by transthoracic echocardiography using leading edge to leading edge convention at end-diastole. Maximum systolic and diastolic blood pressure response to exercise was measured during a standardized exercise test. Results At baseline, median age, max. systolic BP, BMI, diameter of the sinus of Valsalva, and diameter of the ascending aorta were 62 years, 208 mmHg, 26.9 kg/m2, 35mm, and 35mm respectively. 32% of patients were female and 67% had known arterial hypertension. After a median follow-up of 7.1 years, mean growth rate of the sinus of Valsalva and ascending aorta were 0.09 mm and 0.13 mm per year respectively. In univariate and multivariable regression models, there was a small but significant association between baseline aortic diameters and max. systolic BP, as shown in the Table 1. No significant associations were observed between growth rate of aortic diameters and max. systolic BP, as shown in the Table 2. Similar findings were obtained for max. diastolic BP and when considering only individuals with a baseline diameter ≥ 40mm. Conclusion In this large prospective cohort study, there was a small inverse relationship between max. systolic BP during exercise and baseline aortic diameters. However, max. systolic BP during exercise showed no influence on growth rates of aortic diameters. Furthermore, the mean growth rates of aortic diameters per year in this population were in line with growth rates in a normal population.Table 1.Table 2