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Volume 114, Nº 1, January 2020


DOI: http://www.dx.doi.org/10.5935/abc.20190229


Aortic Arch Calcification on Routine Chest Radiography is Strongly and Independently Associated with Non-Dipper Blood Pressure Pattern

Adem Adar

Orhan Onalan

Fahri Cakan

Ertan Akbay

Ekrem Karakaya

Figure 1 – Aortic arch calcification grading.


Background: Non-dipper blood pressure (NDBP) is one of the important causes of hypertension-related target organ damage and future cardiovascular events. Currently, there is no practical tool to predict NDBP pattern. Objectives: The aim of this study was to investigate the relationship between aortic arch calcification (AAC) on chest radiography and NDBP pattern.

Methods: All patients referred for ambulatory BP monitoring test were approached for the study participation. NDBP was defined as the reduction of ≤10% in nighttime systolic BP as compared to the daytime values. AAC was evaluated with chest radiography and inter-observer agreement was analyzed by using kappa statistics. Univariate and multivariate logistic regression analysis was conducted to assess the association of AAC and NDBP pattern. A 2-tailed p-value < 0.05 was considered statistically significant.

Results: A total of 406 patients (median age: 51.3) were included. Of these, 261(64%) had NDBP pattern. Overall, the prevalence of AAC was 230 (57%). Non-dipper group had significantly higher prevalence of AAC (70% vs. 33%, p < 0.0001) as compared to the dipper group. Presence of AAC was a strong and independent predictor of NDBP pattern (OR 3.919, 95%CI 2.39 to 6.42) in multivariate analysis.

Conclusions: Presence of AAC on plain chest radiography is strongly and independently associated with the presence of NDBP pattern. (Arq Bras Cardiol. 2020; 114(1):109-117)

Keywords: Thoracic, Aorta/physiopathology; Calcification; Calcinosis; Cardiomyopathies; Hypertension/imaging diagnosis; Ventricular Function,Left; Antihypertensive Agents/therapeutic use;Blood Pressure Monitoring Ambulatory; Heart Rate.