{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T12:03:34Z","timestamp":1777637014922,"version":"3.51.4"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2018,7,14]],"date-time":"2018-07-14T00:00:00Z","timestamp":1531526400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Telematic Network Center project Fund","award":["\u201cP.O.R. Campania FESR 2007\u20132013 - O.O. 2.1 \/ CUP B25C13000280007\u201d"],"award-info":[{"award-number":["\u201cP.O.R. Campania FESR 2007\u20132013 - O.O. 2.1 \/ CUP B25C13000280007\u201d"]}]},{"name":"Telematic Network Center project Fund","award":["PRIN 2015EASE8Z_004\/MIUR"],"award-info":[{"award-number":["PRIN 2015EASE8Z_004\/MIUR"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,11,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>BACKGROUND<\/jats:title>\n                  <jats:p>Aortic root (AR) dimension (ARD) at the Valsalva sinuses has been associated with incident cardiovascular (CV) events in population-based studies, but this effect could be due to the association with increased left ventricular (LV) mass. There is also uncertainty on how to define clear-cut AR dilatation. Thus, we analyzed the Campania Salute Network (CSN) registry to (i) establish criteria for evaluation of ARD, (ii) propose cut-points for AR dilatation, and (iii) determine whether AR dilatation has prognostic value independent of LV hypertrophy (LVH).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>We analyzed hypertensive patients with available follow-up, in sinus rhythm and free of prevalent valvular and CV disease (n = 8,573). AR exceeding the 75th percentile of the AR z-score (Ao-Z) obtained by comparison with the value predicted by age, sex, and height (i.e., Ao-Z &amp;gt; 0.80) was considered dilated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Patients with baseline-dilated ARD by Ao-Z were more likely to be younger, men, and obese and had higher baseline blood pressure (BP; all &amp;lt;0.02) but similar kidney function as those without ARD dilatation. In multivariable Cox regression model, dilated ARD predicted 36% increased rate of CV events, independently of older age, male sex, systolic BP, LVH, and class of antihypertensive medications used during follow-up (95% confidence interval: 1.07\u20131.71, P = 0.011).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>In the context of a population of treated hypertensive patients, ARD defined by z-score of predicted values is an independent predictor of CV events regardless of LVH and other common confounders.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CLINICAL TRIALS REGISTRATION<\/jats:title>\n                  <jats:p>Trial Number NCT02211365.<\/jats:p>\n               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Angela","family":"Losi","sequence":"additional","affiliation":[{"name":"Hypertension Research Center, Federico II University of Naples, Napoli, Italy"},{"name":"Department of Advanced Biomedical Sciences, Federico II University of Naples, Napoli, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raffaele","family":"Izzo","sequence":"additional","affiliation":[{"name":"Hypertension Research Center, Federico II University of Naples, Napoli, Italy"},{"name":"Department of Translational Medicine, Federico II University of Naples, Napoli, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruno","family":"Trimarco","sequence":"additional","affiliation":[{"name":"Hypertension Research Center, Federico II University of Naples, Napoli, Italy"},{"name":"Department of Advanced Biomedical Sciences, Federico II University of Naples, Napoli, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"de Simone","sequence":"additional","affiliation":[{"name":"Hypertension Research Center, Federico II University of Naples, Napoli, Italy"},{"name":"Department of Translational Medicine, Federico II University of Naples, Napoli, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"De Luca","sequence":"additional","affiliation":[{"name":"Hypertension Research Center, Federico II University of Naples, Napoli, Italy"},{"name":"Department of Advanced Biomedical Sciences, Federico II University of Naples, Napoli, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2018,7,14]]},"reference":[{"key":"2022111615474244500_CIT0001","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.1097\/HJH.0b013e32835f8fda","article-title":"Aortic root dilatation in essential hypertension: prevalence according to new reference values","volume":"31","author":"Milan","year":"2013","journal-title":"J 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