Study On Related Factors Of Ascending Aortic Dilatation In Community Elderly Patients With Essential Hypertension

Background: Hypertension is one of the main reasons causing death due to cardiovascular and cerebrovascular diseases.Patient with long-term hypertension is easy to catch aortic dilatation,which is most likely to occur in the ascending aorta.Ascending aortic dilatation(AAD)progresses very slowly without obvious symptoms,but ultimately it can result into a fatal outcome,among which the greatest danger is to cause aortic dissection or rupture.Elderly people are more likely to have aortic dilatation,especially for elderly patients with hypertension,it is more obligated for them to be cautious about the incidence of ascending aortic dilatation.Objective: Through analyzing the related factors of ascending aorta dilatation in community elderly patients with essential hypertension,this study aims to figure out the possible risk factors which may lead to ascending aorta dilatation,so as to give guidance for the screening,treatment and prognosis evaluation of ascending aorta dilatation in clinical practice.Research Objects and Methods: A total of 1771 cases of elderly essential hypertension in 2014 from various communities of Liaobu Town,Dongguan City of Guandong Province were retrospectively enrolled into this study.Inclusive criteria: 1)Without taking any antihypertensive drugs,patients with systolic blood pressure values measured 3 times not in the same day equal to or more than 140 mm Hg,and/or diastolic blood pressure equal to or more than 90 mm Hg;or patients who had been confirmed as essential hypertension in clinic and now were taking related antihypertensive drugs;2)Patients aged reaching or exceeding 60 years old.Exclusive criteria: Patients with secondary hypertension,congenital heart disease(CHD),rheumatic heart disease,acute and chronic heart failure,malignant tumor,hematopoietic dysfunction,malfunction of liver and kidney,rheumatic immunological disease,ascending aortic aneurysm(diameter ? 45mm),etc.All patients were performed with routine transthoracic echocardiography,blood routine,blood lipids,serum uric acid,serum creatinine,fasting glucose and other examinations.Related medical histories and clinical data of patients were collected for further analysis.Enrolled people were divided into AAD group and normal group based on whether they have ascending aortic dilatation(AAD).The analysis of statistical difference in clinical and demographic indicators between two groups was carried out.Then the univariate/multivariate linear regressive analysis as well as univariate/multivariate logistic regression analysis was conducted in order to identify the correlation between AAD and variables.According to the results,ROC curve was drawn to calculate truncation value when the diagnostic efficiency of variable was optimum and its susceptibility as well as specificity.Meanwhile,the predictive efficiency of the variable for AAD prediction could be evaluated.Results: In total,the study included 1771 patients of elderly hypertension,with average age of 76.9±9.88 years old.The prevalence of AAD was approximately18.0%.In the AAD group,the red blood cell distribution width(RDW)was 13.6±1.4%,which was significantly higher than that of normal group(13.2 ±1.02%).P <0.001.Univariate linear regression analysis indicated that RDW had a positive linear correlation to the aortic inner diameter(B=0.476,S.E=0.178,95% CI:0.127-0.825,P=0.008),but no significant linear correlation was identified after making the multivariate linear regression analysis.Through univariate logistic regression analysis,it was found that RDW had a significant positive correlation to AAD(OR = 1.318,95% CI: 1.197-1.45,P < 0.001),which could be a risk factor for AAD.Next,multivariate logistic regression analysis showed that RDW(OR=1.323,95%CI:1.16~1.508,P<0.001)has a significant positive correlation to AAD,indicating that RDW was an independent risk factor for AAD.The area under curve(AUC)for ROC of RDW was 0.617(95%CI:0.583-0.651).When the truncation value of RDW reached 17.1%,the diagnostic efficiency could be the best,with susceptibility of58.8% and specificity of 60.4%,indicating that RDW would maintain a good level of susceptibility and specificity to the prediction model of AAD.Conclusions: RDW was positively linear correlated to AAD;RDW was an independent risk factor for ADD.Diagnostic efficiency could be the best when the RDW cutoff value was 17.1%,indicating that RDW would maintain a good level of susceptibility and specificity to the prediction model of AAD.