Mortality From Thoracic Aortic Diseases and Associations With Cardiovascular Risk Factors
Background—Temporal trends in mortality from thoracic aortic disease are unclear. This study examined trends in mortality from thoracic aortic aneurysm (TAA) and aortic dissection (AD) with the aim of identifying associations with trends in established cardiovascular risk factors.
Methods and Results—TAA and AD mortality (1994-2010) using ICD codes were extracted from the WHO mortality database and age-standardised. WHO InfoBase and International Mortality and Smoking Statistics provided risk factor data. Eighteen WHO member states were included (Europe=13, Australasia=2, North America=2, Asia=1). Ecological regression was performed of temporal trends in cardiovascular risk factors (1946-2010) and independent correlations to mortality trends. TAA and AD mortality trends show substantial heterogeneity, however, are generally declining. TAA mortality has increased in Hungary, Romania, Japan and Denmark whilst aortic dissection mortality has increased in Romania and Japan therefore the mortality decline is not universal. A linear relationship exists between trends in systolic blood pressure, cholesterol and body mass index and mortality from TAA. BMI demonstrated a negative linear association with female AD mortality whilst trends in systolic blood pressure demonstrated a positive linear relationship with male AD mortality. Trends in smoking prevalence were not associated with TAA or AD mortality trends.
Conclusions—This population level ecological regression provides evidence that mortality secondary to thoracic aortic aneurysm and aortic dissection are both in decline. Differences between countries could be explained by population level changes in common cardiovascular risk factors. Public health measures could further reduce mortality from thoracic aortic aneurysm and aortic dissection.
- Received April 29, 2014.
- Revision received October 1, 2014.
- Accepted October 3, 2014.