Population-based study of incidence and outcome of acute aortic dissection and premorbid risk factor control: 10-year results from the oxford vascular study

  • D.P.J. H
  • A. B
  • J.F. F
 et al. 
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Abstract

BACKGROUND-Acute aortic dissection is a preventable life-threatening condition. However, there have been no prospective population-based studies of incidence or outcome to inform an understanding of risk factors, strategies for prevention, or projections for future clinical service provision. METHODS AND RESULTS-We prospectively determined incidence and outcomes of all acute aortic dissections in a population of 92 728 in Oxfordshire, United Kingdom, from 2002 to 2012. Among 155 patients with 174 acute aortic events, 54 patients had 59 thoracoabdominal aortic dissections (52 incident events: 6/100 000, 95% confidence interval, 4-7; 37 Stanford type A, 15 Stanford type B; 31 men, mean age=72.0 years). Among patients with type A incident events, 18 (48.6%) died before hospital assessment (61.1% women). The 30-day fatality rate was 47.4% for patients with type A dissections who survived to hospital admission and 13.3% for patients with type B dissections, although subsequent 5-year survival rates were high (85.7% for type A; 83.3% for type B). Even though 67.3% of patients were on antihypertensive drugs, 46.0% of all patients had at least 1 systolic BP ≥180 mm Hg in their primary care records over the preceding 5 years, and the proportion of blood pressures in the hypertensive range (>140/90 mm Hg) averaged 56.0%. Premorbid blood pressure was higher in patients with type A dissections that were immediately fatal than in those who survived to admission (mean/standard deviation pre-event systolic blood pressure=151.2/19.3 versus 137.9/17.9; P

Author-supplied keywords

  • 80 and over
  • Aged
  • Aneurysm
  • Aortic Aneurysm
  • Dissecting
  • England
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Population Surveillance
  • Prospective Studies
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • United Kingdom
  • aged
  • antihypertensive agent
  • aorta dissection
  • article
  • cardiovascular risk
  • epidemiology
  • fatality
  • female
  • human
  • hypertension
  • incidence
  • major clinical study
  • male
  • methods
  • outcome assessment
  • population research
  • priority journal
  • prospective study
  • survival rate
  • systolic blood pressure
  • therapy

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Authors

  • Howard D.P.J.

  • Banerjee A.

  • Fairhead J.F.

  • Perkins J.

  • Silver L.E.

  • Rothwell P.M.

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