What does this research mean for the field?

There is no clear overall association between physical activity levels and the risk of aortic dissection, though there may be weak inverse associations for specific walking frequencies and vigorous activity volumes. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The study aimed to explore the relationship between various levels of physical activity and the risk of aortic dissection.

April 18, 2026Open Access

Physical Activity and the Risk of Aortic Dissection: Results from the UK Biobank

Key Points

The study aimed to explore the relationship between various levels of physical activity and the risk of aortic dissection.
Utilized Cox proportional hazards models to analyze data from 452,994 participants.

Structured PICO

Does physical activity reduce the risk of incident aortic dissection in middle-aged to older adults?

Population

452,994 participants aged mainly between 40 and 69 years from the UK Biobank, mean age 56.34, 53.65% female, >95% white ethnicity. Key exclusions: prevalent aortic dissection at baseline, missing data on smoking, BMI, or physical activity.

Intervention

High levels of physical activity (leisure-time, walking, moderate, and vigorous activity) assessed via the International Physical Activity Questionnaire (IPAQ) and measured by frequency and MET-hours/week.

Comparator

Lowest quintile or category of physical activity frequency and MET-hours/week.

Outcome

Incident cases and deaths from aortic dissection (identified by ICD-10 code I71.0 and ICD-9 code 441.0) over a mean follow-up of 12.3 years.hard clinical

In a large prospective UK cohort, there was no clear overall association between physical activity and aortic dissection risk, though a suggestive U-shaped benefit was observed for moderate walking.

Abstract

We investigated the association between physical activity and the risk of aortic dissection in the UK Biobank. The analytical dataset included 452,994 participants aged mainly between 40 and 69 years, recruited from 2006 to 2010. Cox proportional hazards models were used to estimate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between physical activity and the risk of aortic dissection. During 12.3 years follow-up, 331 aortic dissection cases were identified. No clear association was observed between the highest vs. lowest quintile of frequency of leisure-time physical activity (HR, 95% CIs: 0.84, 95% CI: 0.59–1.19; Ptrend = 0.88), moderate physical activity (1.11, 0.71–1.72, Ptrend = 0.51), or vigorous physical activity (1.06, 0.76–1.48, Ptrend = 0.74) and risk of aortic dissection. A suggestive inverse U-shaped association was observed for moderate vs. low levels of walking and aortic dissection risk with HRs (95% CIs) of 1.00 (reference), 0.80 (0.53–1.20), 0.63 (0.41–0.97), 0.63 (0.39–1.02) and 0.78 (0.55–1.11) for walking 2, 4, 5, 6, and 7 times/week, respectively. This association was slightly strengthened after exclusion of participants with prevalent CVD, cancer and respiratory disease at baseline. In analyses using MET-hours/week as the metric, a suggestive inverse association was observed for vigorous physical activity (0.66, 0.43–0.99; Ptrend = 0.09), but not for other physical activity domains. Overall, we found little evidence of a clear association between physical activity and aortic dissection in the current study. Potential U-shaped inverse associations between frequency of walking and the risk of aortic dissection, and between MET-hours/week of vigorous physical activity and aortic dissection need further study in additional large cohort studies.

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