At the KAHN CENTER we diagnose enlarged thoracic aorta size (aneurysm) in many patients on echocardiography and cardiac and chest CT studies, like a calcium CT scan. An enlarged aorta can put a patient at risk for a sudden emergency called an aortic dissection.
Despite its high mortality, prospective, population-based data on incidence and risk factors of AD remain limited.
A new study provides more information on risk factors for AD.
The authors followed 22,171 adults (mean age 57 years; 54.0% female) without baseline aortic disease from pooled ARIC and MESA cohorts for 20 years. Incident AD (n = 97) was adjudicated using ICD codes. Cox regression examined associations between age, sex, smoking, diabetes, and hypertension and AD risk. SBP and DBP defined blood pressure levels were assessed in separate models. A four-variable points score (age, sex, SBP category, smoking) was developed and optimized using Youden's index to identify a binary risk threshold.
AD incidence was 22 per 100,000 person-years, higher in older adults, hypertensives, and current smokers.
Independent predictors included age (double the risk), male sex (67% higher risk), hypertension (2.6x the risk), and current smoking 4-6x the risk). Diabetes was associated with nominally lower risk by 75%.
Elevated SBP (120-129mmHg: 2.5x the risk an ≥140 mmHg 4x the risk) and DBP (80-89mmHg 2x the risk; ≥90mmHg: 2.7x the risk) were associated with higher risk.
The predictive score showed good discrimination with 10- and 20-year cumulative incidence ranging from 0-0.43% and 0.07-1.23%, respectively. T
The high-risk group demonstrating seven-fold higher AD hazard.
In this multi-cohort prospective study, increasing age, male sex, elevated blood pressure, and current smoking were associated with higher AD risk.
An exploratory four-variable score discriminated well, and a binary threshold effectively identified high-risk individuals.
We are learning how to better identify the risk for the life-threatening development of an AD.
At the KAHN CENTER, we will emphasize 1uitting smoking and optimally controlling blood pressure are key. Serial imaging is also important.
