Diagnostic Utility of Chest Radiography in Predicting Long-Standing Systemic Arterial Hypertension

Abstract

Purpose: To investigate the association between aortic arch width on frontal chest radiography and systemic hypertension. Methods: A total of 200 consecutive patients were included. Relationships between aortic arch width measurement on chest radiography and blood pressure measurement were investigated using Student's t -tests and Fisher's exact tests. Results: Twenty-five patients were normotensive (< 130/90 mmHg), and 175 were hypertensive. Using cut-off values, 136 patients had an aortic arch width ≥ 3.5 cm, and 65 had an aortic arch width ≥ 4 cm. We found a significant relationship between aortic arch width and hypertension (p < 0.001) as well between aortic arch width cut-off values of 3.5 cm and 4 cm and hypertension (p < 0.001 and p < 0.005, respectively). An aortic arch width ≥ 3.5 cm was associated with a positive likelihood ratio (LR) of 2.3, negative LR of 0.39, sensitivity of 73, specificity of 68, positive predictive value of 94, negative predictive value of 26.6, pretest odds of 7, posttest odds of 16, and posttest probability of 94%. An aortic arch width ≥ 4 cm was associated with a positive LR of 4.50, negative LR of 0.70, sensitivity of 36, specificity of 92, positive predictive value of 97, negative predictive value of 17, pretest odds of 7, posttest odds of 31.5, and posttest probability of 97%. Conclusions: Aortic arch width measurement on chest radiography can be used to predict the presence of long-standing systemic arterial hypertension.