DILATATION AND UNFOLDING OF THE AORTA IN A JAMAICAN POPULATION

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Abstract
In an analysis of 2085 70-mm chest X-rays of subjects aged 35-64 from a rural population in Jamaica, 79 of the 995 men (7.9%) and 92 of the 1090 women (8.4%) showed some degree of aortic dilatation. The clinical examination of these people and age and sex balanced control groups drawn by random methods from the same population revealed 3 main findings. (1) Arterial pressure levels were consistently higher in the affected, than in the controls. (2) The condition was associated with aortic regur-gitation in 20% of men and 7% of women. (3) Both aortic dilatation and arterial pressure in these subjects were apparently unrelated to their present serological status. Positive serological reactions for syphilis and for yaws were found in about 25% of affected and controls. The possible role of syphilis and/or yaws in association with hypertension in producing aortic dilatation is discussed. A relationship between aortic dilatation, often gross, and hypertension has been demonstrated and this combination appears to have a high prevalence in West Indian Negroes. Whatever the role of treponemal infection it is apparently not the most important single factor in the production of either the aortic dilatation, the associated hypertension, or the resulting aortic regurgitation. The significance of uncomplicated aortic dilatation, in terms of morbidity and mortality, remains to be determined by follow-up studies of these groups.

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