Assessment of management of cardiovascular risk factors in patients with thoracic aortic disease

Abstract

Background: Cardiovascular risk profiles and adiposity assessment data in patients with thoracic aortic disease (TAD) are sparse.

Hypothesis: Despite the fact that TAD patients are considered as a high-risk population, they will not be managed as aggressively as they should in terms of their cardiovascular risk profile.

Materials and methods: Anthropometric, blood pressure (BP) data, and blood samples were collected prospectively from patients followed at our TAD dedicated clinic. The same measures have been taken in a control group initiating a cardiac rehabilitation program.

Results: In all, 286 patients with TAD and 116 controls were recruited. BMI was higher among the controls than the patients with TAD (30.0±6.1 vs. 27.2±4.9 kg/m(2), respectively; P<0.001). We found no statistical difference between the groups for waist circumference (TAD: 93.1±15.2 and 103.6±14.5 cm, control: 95.0±13.4 and 106.3±14.8 cm, respectively, for women and men; P=0.06). In terms of lipid profile, low-density lipoprotein cholesterol was 2.44±0.88 in patients with TAD and 2.09±0.82 mmol/l in the controls (P<0.001). A higher percentage of patients with TAD had low-density lipoprotein cholesterol values that were beyond the target (63.3% in TAD vs. 46.1% in control; P<0.01). The values of apolipoprotein-B were similar between groups (P=0.41). BP was higher in patients with TAD (135±19/76±11 mmHg) versus the controls (129±17/71±11 mmHg; P<0.01). On the basis of ambulatory BP monitoring, 49.3% of patients with TAD were not well controlled for daytime and/or night-time BP.

Conclusion: Cardiovascular risk factors, particularly BP, are not well controlled in patients with TAD followed in a dedicated clinic when compared with another high-risk control group in a cardiac rehabilitation program.