Key result
Stage 2 hypertension increased the risk of aortic dissection, whereas diabetes was associated with a decreased risk.
Why the study?
Data on the dose-dependent association of blood pressure and fasting plasma glucose level with the risk of aortic dissection and aortic aneurysm were limited.
Do blood pressure and fasting plasma glucose levels affect the risk of aortic dissection and aneurysm in individuals without prior cardiovascular disease?
Cohort (n=3,358,293)
Yes
Do blood pressure and fasting plasma glucose levels affect the risk of aortic dissection and aneurysm in individuals without prior cardiovascular disease?
Answers are grounded in this paper and cite their sources.
Higher blood pressure is associated with a dose-dependent increase in the risk of aortic dissection and aneurysm, whereas higher fasting plasma glucose is associated with a decreased risk.
AIMS: Data on the dose-dependent association of blood pressure (BP) and fasting plasma glucose (FPG) level with the risk of aortic dissection (AD) and aortic aneurysm (AA) are limited. METHODS AND RESULTS: This observational cohort study included 3 358 293 individuals registered in a health checkup and claims database in Japan [median age, 43 (36-51) years; 57.2% men]. Individuals using BP- or glucose-lowering medications or those with a history of cardiovascular disease were excluded. In a mean follow-up period of 1 199 ± 950 days, 1 095 and 2 177 cases of AD and AA, respectively, were recorded. Compared with normal/elevated BP, hazard ratios (HRs) of Stage 1 and Stage 2 hypertension were 1.89 [95% confidence interval (CI): 1.60-2.22] and 5.87 (95% CI: 5.03-6.84) for AD and 1.37 (95% CI: 1.23-1.52) and 2.17 (95% CI: 1.95-2.42) for AA, respectively. Compared with normal FPG level, HRs of prediabetes and diabetes were 0.82 (95% CI: 0.71-0.94) and 0.48 (95% CI: 0.33-0.71) for AD and 0.94 (95% CI: 0.85-1.03) and 0.61 (95% CI: 0.47-0.79) for AA, respectively. The cubic spline demonstrated that the risk of AD and AA increased with increasing BP but decreased with increasing FPG level. Contour plots using generalized additive models showed that higher systolic BP and lower FPG level were associated with an elevated risk of AD and AA. CONCLUSIONS: Our analysis showed a dose-dependent increase in the risk of AD or AA associated with BP and a similar decrease associated with FPG, and also suggested a potential interaction between hypertension and hyperglycaemia in the development of AD and AA.
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Suzuki et al. (2022) conducted a cohort in Aortic dissection and aortic aneurysm (n=3,358,293). Hypertension and hyperglycemia vs. Normal blood pressure and normal fasting plasma glucose was evaluated on Aortic dissection (HR 5.87, 95% CI 5.03-6.84). Stage 2 hypertension increased the risk of aortic dissection, whereas diabetes was associated with a decreased risk.
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