Aortic Arch Calcification on Routine Chest Radiography is Strongly and Independently Associated with Non-Dipper Blood Pressure Pattern

• Published in: Arquivos brasileiros de cardiologia Vol. 114; no. 1; pp. 109 - 117
• Main Authors: Adar, Adem, Onalan, Orhan, Cakan, Fahri, Akbay, Ertan, Karakaya, Ekrem
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil Sociedade Brasileira de Cardiologia - SBC 01.01.2020; Sociedade Brasileira de Cardiologia (SBC)
• Subjects: Adult; Aged; Antihypertensive Agents/therapeutic use; Aortic Diseases - diagnostic imaging; Aortic Diseases - physiopathology; Blood Pressure - physiology; Blood Pressure Monitoring Ambulatory; Calcification; Calcinosis; CARDIAC & CARDIOVASCULAR SYSTEMS; Cardiomyopathies; Circadian Rhythm; Female; Heart Rate; Humans; Hypertension/imaging diagnosis; Male; Middle Aged; Original; Radiography, Thoracic; Risk Factors; Severity of Illness Index; Thoracic, Aorta/physiopathology; Vascular Calcification - diagnostic imaging; Vascular Calcification - physiopathology; Ventricular Function,Left; Antihypertensive Agents/therapeutic use; Calcinose; Heart Rate; Calcificação; Anti-Hipertensivos/uso terapêutico; Cardiomiopatias; Hipertensão/diagnóstico por imagem; Thoracic, Aorta/physiopathology; Aorta Torácica/fisiopatologia; Ventricular Function,Left; Função Ventricular Esquerda; Frequência Cardíaca; Calcinosis; Hypertension/imaging diagnosis; Calcification; Cardiomyopathies; Monitoração Ambulatorial da Pressão Arterial; Blood Pressure Monitoring Ambulatory
• ISSN: 0066-782X; 1678-4170; 1678-4170
• DOI: 10.5935/abc.20190229

Non-dipper blood pressure (NDBP) is one of the important causes of hypertension-related target organ damage and future cardiovascular events. Currently, there is no practical tool to predict NDBP pattern. The aim of this study was to investigate the relationship between aortic arch calcification (AAC) on chest radiography and NDBP pattern. All patients referred for ambulatory BP monitoring test were approached for the study participation. NDBP was defined as the reduction of ≤10% in nighttime systolic BP as compared to the daytime values. AAC was evaluated with chest radiography and inter-observer agreement was analyzed by using kappa statistics. Univariate and multivariate logistic regression analysis was conducted to assess the association of AAC and NDBP pattern. A 2-tailed p-value < 0.05 was considered statistically significant. A total of 406 patients (median age: 51.3) were included. Of these, 261(64%) had NDBP pattern. Overall, the prevalence of AAC was 230 (57%). Non-dipper group had significantly higher prevalence of AAC (70% vs. 33%, p < 0.0001) as compared to the dipper group. Presence of AAC was a strong and independent predictor of NDBP pattern (OR 3.919, 95%CI 2.39 to 6.42) in multivariate analysis. Presence of AAC on plain chest radiography is strongly and independently associated with the presence of NDBP pattern.