LAUSR

AIM 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 This observational cohort study included 3,358,293 individuals registered in a health check-up 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. RESULTS 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, HRs of stage 1 and stage 2 hypertension were 1.89 (95% 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, 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 SBP 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 with BP and a similar decrease associated with FPG, and also suggested a potential interaction between hypertension and hyperglycemia in the development of AD and AA.