Abstract

The aim of the study was to asses the atheromatous changes in the aorta in middle-aged hypertensive pts and their correlations with the 24-h blood pressure (BP) monitoring data and the atherogenic lipids. 29 persons (14 female and 15 male) mean age 46,5 yrs, with essential hypertension were studied. A 24-h BP monitoring was performed. LDL, HDL - and cholesterol and triglycerides were measured. The changes in the aorta were evaluated by chest X-ray and transesophageal echocardiography (TEE). The size of the aorta was measured at different levels and the atherosclerotic changes in the aortic wall were classified in 5 types: type 1, normal intima; type 2, increased echogenity, abnormal density; type 3, thickened > 2 mm intima; type 4, atherosclerotic plaques with d < 3 mm; type 5, plaques with d > 3 mm, ulcerated, prominent in the aortic lumen, pediculated.

The pts were distributed by TEE type as follow: type 1, 15 pts; type 2, 4 pts; type 3, 6 pts; type 4, 3 pts; and type 5, none. The size of the aorta increased paralelly with the increase of the severity of the atherosclerotic process. While analyzing the serum lipids in different types of aortic lesions we only obtained significantly higher values for the total cholesterol in type 3. The diastolic BP proved significantly higher in type 3 and type 4 as compared with type 1 and type 2. The chest X-ray examination of the aorta revealed increased relative height and width of the aorta as comapred with the refernce values.

The results of the study suggest that the investigation of the aorta by means of available tarditional methods such as X-ray or TEE should be included in the overall clinical assesment of the hypertensive patient.

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