Mortality From Thoracic Aortic Diseases and Associations With Cardiovascular Risk Factors | Journal Scan

Study Questions:

What are the temporal trends in mortality associated with thoracic aortic aneurysms (TAAs) and aortic dissections (ADs), and are these changes associated with trends in cardiovascular risk factors?

Methods:

This study used the World Health Organization mortality database to examine trends in TAA and AD mortality using ICD codes between 1994 and 2010 in 18 countries. Trends in cardiovascular risk factors were also evaluated and compared to rates of mortality from TAA and AD.

Results:

Mortality from TAA and AD is declining in most countries, although increased mortality from TAA was observed in Denmark (both genders), Japan (both genders), and Romania (males), while increased mortality from AD was seen in Japan (both genders) and the Netherlands (females). There was a linear relationship between death from TAA and increased systolic blood pressure in males (p = 0.02) and females (p = 0.01), increased cholesterol in males (p = 0.01) and females (p = 0.03), and decreased body mass index in males (p = 0.02) and females (p = 0.02). There was a linear relationship between death from AD and systolic blood pressure in men (p = 0.048), and with decreased body mass index in women (p = 0.03). There was no significant linear relationship between smoking or fasting blood glucose and death from AD or TAA.

Conclusions:

Mortality from TAA and AD is declining in most countries, and there is a linear relationship between cardiovascular risk factors and death from these diseases.

Perspective:

While most countries experienced a decline in mortality from TAA and AD, a few countries noted increases during this time period, which should prompt further examination into the causes of this disparity and ways to prevent these excess deaths. The linear relationship between cardiovascular risk factors and mortality from TAA and AD support the possibility that these risk factors may contribute to observed trends in mortality, although this study cannot determine cause and effect.

Clinical Topics: Cardiac Surgery, Dyslipidemia, Vascular Medicine, Aortic Surgery, Lipid Metabolism, Nonstatins

Keywords: Aneurysm, Dissecting, Aortic Aneurysm, Thoracic, Blood Pressure, Body Mass Index, Cholesterol, Clinical Coding, Denmark, International Classification of Diseases, Japan, Netherlands, Risk Factors, Romania


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