Phenotypic predictors of aortic root dilation in essential hypertension

Several life-threatening complications can develop in the ascending aorta, which include dissection or rupture of an aortic aneurysm. Those at high risk of developing such complications can be categorised according to the types of thoracic aneurysms. Older individuals (age >59 years), and especially men, with atherosclerotic disease including hypertension are vulnerable to develop supravalvular aortic aneurysms (above the sinuses of Valsalva).1 Aortic root (AR) aneurysms occur mostly in younger individuals (age <50 years) and affect men and women equally.1,2 In addition, AR aneurysms are believed to be of idiopathic origin, but often occur in specific conditions such as Marfan’s syndrome, Ehler Danlos syndrome, bicuspid valve connective tissue disorders or in rare bacterial infections of the endocardium.3 The echocardiographic measurement of the AR diameter remains a clinical marker of aortic root dilation (ARD). A dilated ascending aorta of 50 mm or greater is considered a risk factor for dissection or aortic rupture.4