Trends in Thoracic Aortic Aneurysms and Dissection: Out of the Shadows and Into the Light
In this issue of Circulation, Sidloff and colleagues have presented their findings that, among 18 World Health Organization member states over a period of 16 years (from 1994 to 2010), there has been a reduction in the age-standardized mortality from both thoracic aortic aneurysm and dissection.1 If one considers the United States, the United Kingdom, and Sweden—three countries that have published extensively on the prevalence and mortality of thoracic aortic disease—the trends are quite favorable: Mortality from thoracic aortic aneurysm has declined by approximately 5-10% among males and 3-6% among females; and mortality from aortic dissection has declined by about 2-3% among males and 1-2% among females. However, and not surprisingly, the investigators discovered heterogeneity among mortality trends by country. For example, for males with thoracic aortic aneurysms, while there was a statistically significant reduction in mortality over time in 13 of the 18 countries, in 3 countries there was instead an increase in mortality. Similarly, for males suffering aortic dissection, while there was again a statistically significant reduction in mortality over time in 13 of the 18 countries, in one country there was a significant rise in mortality. Japan and Romania were the two countries with the most consistent increases in mortality.
- Received November 9, 2014.
- Accepted November 10, 2014.