Cohort Study Examining the Association of Optimal Blood Pressure Control at Entry With Infrarenal Abdominal Aortic Aneurysm Growth

Diana Thomas Manapurathe; Joseph Vaughan Moxon; Smriti Murali Krishna; Frank Quigley; Michael Bourke; Bernard Bourke; Rhondda E Jones; Jonathan Golledge

doi:10.3389/fcvm.2022.868889

Cohort Study Examining the Association of Optimal Blood Pressure Control at Entry With Infrarenal Abdominal Aortic Aneurysm Growth

Front Cardiovasc Med. 2022 May 3:9:868889. doi: 10.3389/fcvm.2022.868889. eCollection 2022.

Authors

Diana Thomas Manapurathe¹, Joseph Vaughan Moxon^{1

2}, Smriti Murali Krishna^{1

2}, Frank Quigley³, Michael Bourke^{1

4}, Bernard Bourke^{1

4}, Rhondda E Jones², Jonathan Golledge^{1

2

5}

Affiliations

¹ Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia.
² The Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia.
³ Mater Hospital, Townsville, QLD, Australia.
⁴ Gosford Vascular Services, Gosford, NSW, Australia.
⁵ Department of Vascular and Endovascular Surgery, The Townsville University Hospital, Townsville, QLD, Australia.

Abstract

Background and aim: The benefit of controlling cardiovascular risk factors in slowing the progression of small abdominal aortic aneurysm (AAA) is controversial. This study investigated the association of optimal blood pressure control at entry with the growth of small AAA.

Methods and results: A total of 1,293 patients with initial AAA diameter <50 mm were followed by a median 5 (inter-quartile range, IQR, 3-7) ultrasound scans for a median of 3.6 years (IQR 1.8, 5.3). Optimal blood pressure control was defined as blood pressure ≤140/90 mmHg at recruitment. The association of optimal blood pressure control at entry with AAA growth was assessed using linear mixed effects models adjusted for established risk factors of AAA growth and factors which were unequally distributed among the blood pressure groups. Optimal blood pressure control at entry was not significantly associated with AAA growth. In the risk factor adjusted model the mean difference in AAA growth between blood pressure groups was 0.04 mm/year (95% CI -0.20, 0.13; p = 0.65). The results were similar in sensitivity analyses excluding outliers or focused on systolic or diastolic blood pressure alone.

Conclusions: This observational study suggests that optimal blood pressure control at entry is not associated with slower AAA growth.

Keywords: AAA growth; abdominal aortic aneurysm; diastolic blood pressure; hypertension; systolic blood pressure.