Left ventricular hypertrophy and abdominal aorta size in essential hypertension

To investigate the association between subclinical organ damage and abdominal aortic diameter in a large cohort of uncomplicated essential hypertensive patients. Subclinical markers of organ damage (i.e. left ventricular mass, carotid intima-media thickness and plaques, microalbuminuria and retinal changes) and abdominal aortic diameter (ultrasonography) were assessed in 2430 (mean age 53 ± 13 years) untreated and treated hypertensive patients included in the Evaluation of Target Organ Damage in Hypertension (ETODH) study. In the whole study population, left ventricular mass index was the most important correlate (β = 0.418, P < 0.0001) of the absolute abdominal aortic diameter and, after age, (β = 0.268, P < 0.0001) of abdominal aortic diameter indexed to body surface area (abdominal aorta index, AAI). In a sex-based analysis, a stepwise increase in left ventricular mass index as well as in prevalence of left ventricular hypertrophy (LVH), carotid intima-media thickness and plaques occurred from the lower to the upper quartile of AAI in men, but not in women. No correlations were found between AAI and microalbuminuria or retinal changes. Our findings support a sex-specific relation between abdominal aorta size and subclinical organ damage by showing that LVH in hypertensive men is an independent correlate for enlarged abdominal aorta. On the basis of these data, diagnostic protocols for detecting subclinical alterations in the abdominal aorta should be optimized.