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Experts say doctors should screen more often for a wide thoracic aorta. Kckate16/Getty Images
  • Researchers say a wider thoracic aorta could be a warning sign about your risk of a heart attack or stroke.
  • They add the risk can be greater in women than in men.
  • Experts recommend that doctors screen more often to check the width of a person’s thoracic aorta.

Your doctor could have another way to gauge your risk of heart attack and stroke.

A new study says the clues lie in the diameter of your thoracic aorta. That’s the portion of the large artery that passes through your chest and carries oxygenated blood to your heart and other parts of your body.

The aorta gets wider as we age and a widened thoracic aorta could mean your risk is greater.

In their study, researchers looked at the CT scans of 2,100 participants from the Netherlands. The participants’ median age was 69 and 55 percent were women.

The scans were taken between 2003 and 2006 as part of the larger Rotterdam Study. The research participants were followed for approximately nine years. The scientists accounted for the participants’ size or body mass index.

“Our results suggest that imaging-based assessment of the diameter of the thoracic aorta can be considered as a risk marker for future cardiovascular disease, ” said Dr. Maryam Kavousi, the study’s senior author and an associate professor of epidemiology at The Erasmus Medical Center at the University Medical Center in the Netherlands.

And Kavousi says they found different outcomes for men and women.

“We found that greater ascending aortic diameter was associated with a 33 percent higher cardiovascular mortality risk among women, ” she told Healthline. “Remodeling of the aging aorta seems to be different between women and men, with unfavorable dynamics of aortic growth and faster deterioration in aortic health in women.”

Kavousi says the information could be gleaned from screening tests.

“Thoracic aorta size assessment could easily be added to existing screening methods,” she said. “The cardiac CT scans deployed in our study are already commonly used to assess coronary calcium. The thoracic aortic diameter could also be measured routinely, for example as part of CT-based lung cancer screening.”

“This study is looking at relatively small, incremental increases in size from the sort of the normal lane change into the upper range of normal…or into the lower range of abnormal, ” said Dr. Paul D. Natterson, a cardiologist at Providence Saint John’s Health Center in Santa Monica, California.

“Typically in practice… when we look at the aorta, we are thinking in terms of what is the risk that the aorta will get so big that it either tears or ruptures… Aortas that are typically going to be 50 percent bigger than the normal size should be [looked at],“ he told Healthline.

Healthline asked Natterson if there should be screening for the aortic diameter.

“We generally don’t do screening measurements of ascending and descending aorta. It’s often picked up on something else, scans, ultrasounds, or MRIs that are being done for other reasons” he responded.

“If we have endless resources, equipment, and money, I think screening is an amazing thing, “ he said. “The realities are that it’s probably not realistic to do CT scans across the population.”

In an editorial written about the study, one researcher said more work is needed. In one example, she says the CT scans were done without contrast. The use of contrast might have made for more accurate measurements.

“Further work is needed to help translate these findings into management recommendations for individual patients. Unanswered essential questions remain… including which measurements we should perform and which patients benefit from further assessment,” wrote Michelle C. Williams, Ph.D., a senior clinical lecturer and radiology consultant at the University of Edinburgh. She is also associate director of the British Heart Foundation Data Science Center.

Natterson said doctors have to make sure they manage the risk factors that can lead to aortic enlargement.

“You have to make sure you’re addressing hypertension, tobacco use, lipid management, lifestyle management, and making sure there are no genetic predispositions,” he said. “It may mean more blood screening.”

“We often already screen for calcification of the coronary arteries and pick up on aortic dimensions on those scans,” he added. “We’re always looking for other tools to identify people who are at greater risk and this could be something down the road that sort of fits into algorithms and workflows.”

Kavousi says a dilated thoracic aorta is most often asymptomatic. She wants practitioners to keep the study results on their radar.

“As always, promotion of a healthy lifestyle, screening for risk factors, and preventive treatment of elevated risk factors are of the utmost importance,” she said.

“The findings of our study suggest that cardiovascular risk assessment associated with thoracic aortic size among asymptomatic women and men could lead to effective, sex-specific prevention strategies,” she added.