Unrecognised aneurysmal disease in male hypertensive patients.

The risk of an aneurysm leaking is related to its size. The operative mortality of elective surgery should be less than 5% but is frequently more than 50% following rupture. Many patients previously undiagnosed present with rupture, yet are on long-term treatment for hypertension. Two-hundred hypertensive male patients over the age of 50 have been clinically examined, and subsequently undergone ultrasound examination of the abdominal aorta. Fourteen asymptomatic aneurysms were detected, 9 on clinical examination, confirmed by ultrasound and C.T., and a further 5 detected by ultrasound, and also confirmed by C.T. Twenty-four patients were found to have carotid bruits, in 12 of whom the bruits were bilateral. Sixty-seven patients were found to have peripheral vascular disease. Routine abdominal ultrasound examination should be included in the regular assessment of hypertensive patients.