Association with Uncontrolled Hypertension in Thoracic Aortic Aneurysm Patients Referred to a Tertiary-Care Center

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Background: International guidelines recommend tight blood pressure (BP) control in patients with thoracic aortic aneurysm (TAA). Hypertension in TAA patients has been associated with an increased rate of aneurysm growth and also with aortic dissection or aortic rupture. We aimed to study BP control in TAA patients referred by a primary or cardiology provider to a tertiary aortic management program. Methods: This retrospective study analyzed 3525 consecutive patients with confirmed TAA diagnosis referred by a primary-care or cardiology provider for management at the Lankenau Aortic Surgical Program between January 2021 and December 2024. Blood pressure was registered using an appropriately sized cuff and a calibrated automated sphygmomanometer. Clinical and demographic data were compared between patients with different stages of hypertension, based on the 2023 ESH guidelines. Results: The overall rate of above-target BP in TAA patients was 54.2% (1911/3525). From the hypertension group, Stage 1 (BP > 140/90) accounted for 53.4% (1020/1911) of patients, with Stage 2 (BP > 160/100) accounting for 12.6% (241/1911) and Stage 3 (BP > 180/110) for 1.8% (35/1911). Among associations of hypertension with demographic data by zip code, no significant differences were observed between groups with respect to race, median household income, or house value. There was a tendency of lower BP in patients from residential areas with higher rates of college graduates compared to those without college education (OR: 0.995; p = 0.059). Conclusions: Hypertension remains both highly prevalent and inadequately controlled in patients with TAA, even within specialized care environments. These findings emphasize the need for a more comprehensive approach to risk factor management to improve outcomes in this high-risk population.

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