Ultrasound Measurement of the Abdominal Aortic Diameter in a Normotensive and Hypertensive Adult Nigerian Population in Enugu

Main Article Content

O. D. Agu
F. U. Uduma
N. R. Njeze
S. O. Mgbor
E. N. Obikili
K. C. Eze

Abstract

Background: Hypertension has direct effect on abdominal aortic diameter. Some of its manifestations are aortic aneurysm and dissection.

Aims: To compare the AAD among adult normotensive and hypertensive subjects as well as correlating with age, sex and blood pressure.

Materials and Methods: Participants will be randomly selected from hypertensives attending Cardiology Clinic, in University of Nigeria teaching hospital (UNTH) Enugu, Nigeria.  Controls will be apparently healthy normotensive volunteers. Participants’ demographics, weight, height and blood pressure will be documented. Ultrasound measurements of infrarenal AAD will be taken at 2 cm below the origin of the superior mesenteric artery.  Data will be statistically analyzed and a p-value of ≤ 0.05 will be considered significant.

Results:  300 participants: comprising of 150 normotensives and 150 hypertensives were studied. The mean values for AAD in normotensive males and females were 16.66 ± 2.04 mm and 15.36 ± 1.97 mm respectively. Whereas the values for hypertensives, changed to 18.89 ± 2.64 mm and 16.57 ± 2.54 mm respectively. The AAD showed a positive correlation with systolic blood pressure (r2 = 0.317, P ≤ 0.001) but not with diastolic blood pressure.

Conclusion: Abdominal aortic diameter was significantly larger among hypertensives than normotensives. The diameter increased with age in both normotensive and hypertensive subjects.

Keywords:
Hypertensives, normotensives, abdominal aortic diameter, ultrasound.

Article Details

How to Cite
Agu, O. D., Uduma, F. U., Njeze, N. R., Mgbor, S. O., Obikili, E. N., & Eze, K. C. (2019). Ultrasound Measurement of the Abdominal Aortic Diameter in a Normotensive and Hypertensive Adult Nigerian Population in Enugu. Journal of Advances in Medicine and Medical Research, 30(6), 1-9. https://doi.org/10.9734/jammr/2019/v30i630203
Section
Original Research Article

References

Breyer B, Bruguera CA, Gharbi HA, Goldberg BB, Tan FEH, Wachira WW, et al. Manual of Diagnostic Ultrasound, ed. Palmer,PES, World Health Organization, Geneva. 2006;6:53-63.

William EB. The core curriculun ultrasound; Lppincott Williams & Wilkins; Phiadelphia. 2001;11:421-423.

Obikili EN, Okoye IJ. Transverse thoracic aortic diameter in frontal chest radiographs of an adult Nigerian population. West Afr J Med. 2006;25(3):186-189.

Blanchard JF. Epidemiology of abdominal aortic aneurysms. Epidemiol Rev. 1999;21:207-21.

Schlatmann TJ, Becker AE. Histologic changes in the normal aging aorta: Implications for dissecting aortic aneurysm. Circulation. 1997;96(7):2228-2232.

Patel AS, Mackey RH, Wildman RP, Thompson T, Mathews K, Kuller L, et al. Cardiovascular risk factors associated with enlarged diameter of the abdominal aortic and iliac arteries in healthy women. Atherosclerosis. 2005;178(2):3ll-7.

Udemezue OO, Akpuaka FC, Anibeze CIP, Mgbor SO. Body habitus and abdominal aortic size among southeast Nigerian. J Expt Clin Anat. 2002;1:22-25.

Cole WC, Hill GB, Bouchard AG. Atherosclerotic risk factors in abdominal aortic aneurysm and peripheral vascular occlusive disease. Chronic Dis Can. 1994;15:120-122.

Lederle FA, Johnson GR, Wilson SE, Chute EP, Littooy FN, Bandyk D, et al. Prevalence and associations of abdominal aortic aneurysm detected through screening. Aneurysm detection and management (ADAM) veterans affairs cooperative study group. Ann Intern Med. 1997;126(6):441-449.

Vazquez C, Sakalihasan N, D’Harcour J. Routine ultrasound screening for abdominal aortic aneurysm among 65- and 75-year-old men in a city of 200,000 inhabitants. Ann Vasc Surg. 1998;12:544-9.

Huseyin O, Serpil S, Bahattin B, Cagri S, Ilker B, Ufuk G. Diameter of the infrarenal abdominal aorta in children with cerebral palsy. Ann Vasc Surg. 2005;19:343-346.

Shweta B, Hamad G, Vikram S. Sonographic evaluation of the abdominal aorta ultrasound. Clin. 2007;2:437–453.

Paul N, Max L, Carole P, Konrad J. Infrarenal aortic diameter predicts all-cause mortality. Arteriosclerosis, Thrombosis, and Vascular Biology. 2004;24:1278-1282.

Markku PJ, Merikanto J, Jerkkola T, Savolainen MJ, Rantala AO, Kauma H, et al. Effect of hypertension and risk factors on diameters of abdominal aorta and common iliac and femoral arteries in middle-aged hypertensive and control subjects: A cross-sectional systematic study with duplex ultrasound. Atherosclerosis. 2000;153(1):99-106.

Brosnan M. Is there a benefit to screening for abdominal aortic aneurysm in the irish male population between the ages of 55 to 75 years; An ideal opportunity group for evaluating cardiovascular risk factors? Dublin Institute of Technology. Masters Thesis; 2011.

Berry CL. Hypertension and arterial development Long-term considerations. Br Heart J. 1978; 40(7):709-717.

O'Kelly TJ, Heather BP. General practice-based population screening for abdominal aortic aneurysms: A pilot study B J Surg. 1989;76(5):479-480.

Eric MI. Contemporary reviews in cardiovascular medicine, thoracic and abdominal aortic aneurysms. Circulation. 2005;11:816-828.

Singh K, Jacobson BK, Solberg S, Kumar S, Arnsen E. The difference between ultrasound and computed tomography measurements of aortic diameter increases with aortic diameter: Analysis. Eur J. Vasc Endovasc Surg. 2004;28(2):158-167.

Strachan DP. Predictors of death from aortic aneurysm among middle-aged men: The white hall study. Br J Surg. 1991;78:401-402.

Ryo T, Satoshi H, Masanori A, Yoshiro T, Kimihiko M, Kiminobu T. Impact of obstructive sleep apnea on abdominal aortic diameters. American Journal of Cardiology. 2014;114(4):618–623.

Gail AL, Matthew AA, Nicole J, Victor A, Nathan DW, Robert D, et al. Abdominal aortic diameter and vascular atherosclerosis: The multi-ethnic study of atherosclerosis. Eur J Vasc Endovasc Surg. 2011;41(4):481–487.

Matthew AA, Kevin K, Dominic D, Michael W, Michael HC. The epidemiology of abdominal aortic diameter. J Vasc Surg. 2008;48(1):121-127.
Available:http://dx.doi.org/10.1016/j.jvs.2008.02.031

Christodoulos S, John D, Charalambos V, Costas T, Eleftherios T, Konstantinos T et al. Aortic function in arterial hypertension determined by pressure-diameter relation: Effects of diltiazem. Circulation. 1997; 96:1853-1858.

Reider B, Torbjon D, Toril ANH. Ultrasound in abdominal aortic aneurysm. INTECH Open Access Publisher; 2011.
DOI: 10.5772/19637, ISBN 978-953-307-466-5
Available:http://www.intechopen.com/books/diagnosis-screening-and-treatment-of-abdominal-thoracoabdominal-and-thoracic-aortic-aneurysms/ultrasound-in-abdominal-aortic-aneurysm

Gary FM, Yves L, Jean-Pascal O, Joseph LI, Joel N, Linda JK et al. Determinants of elevated pulse pressure in middle-aged and older subjects with uncomplicated systolic hypertension: The role of proximal aortic diameter and the aortic pressure-flow relationship. Circulation. 2003;108: 1592-1598.

Ekwunife OI, Aguwa CN. A meta-analysis of prevalence rate of hypertension in Nigerian populations. JPHE. 2011;3(13): 604-607.

Pleumeekers HJ, Hoes AW, Does VE. Aneurysms of the abdominal aorta in older adults: The rotterdam study. Am J Epidemiol. 1995;142:1291-1299.

Wilmink AB, Quick CR. Epidemiology and potential for prevention of abdominal aortic aneurysm. Br J Surg. 1998;85(2): 155-62.

Jaakkola P, Hippelainen M, Oksala I. Infrarenal aortofemoral bypass surgery: Risk factors and mortality in 330 patients with abdominal aortic aneurysm or aortoiliac occlusive disease. Ann Chir Gynaecol. 1996;85:28–35.