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@article{Hibino:2022:10.1161/CIRCULATIONAHA.121.056546,
author = {Hibino, M and Otaki, Y and Kobeissi, E and Pan, H and Hibino, H and Taddese, H and Majeed, Z and Verma, S and Konta, T and Yamagata, K and Fujimoto, S and Tsuruya, K and Narita, I and Kasahara, M and Shibagaki, Y and Iseki, K and Moriyama, T and Kondo, M and Asahi, K and Watanabe, T and Watanabe, T and Watanabe, M and Aune, D},
doi = {10.1161/CIRCULATIONAHA.121.056546},
journal = {Circulation},
pages = {633--644},
title = {Blood pressure, hypertension and the risk of aortic dissection incidence and mortality: results from the Japan-specific health checkups study, the UK biobank study and a metaanalysis of cohort studies},
url = {http://dx.doi.org/10.1161/CIRCULATIONAHA.121.056546},
volume = {145},
year = {2022}
}

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TY  - JOUR
AB  - Background: Hypertension or elevated blood pressure (BP) is an important risk factor for aortic dissection (AD); however, few prospective studies concerning this topic have been published. We investigated the association between hypertension/elevated BP and AD in two cohorts and conducted a meta-analysis of published prospective studies, including these two studies.Methods: We analyzed data from the Japan Specific Health Checkups (J-SHC) Study and UK Biobank, which prospectively followed 534,378 and 502,424 participants, respectively. Multivariable Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the association of hypertension/elevated BP with AD incidence in the UK Biobank and AD mortality in the J-SHC Study. In the meta-analysis, summary relative risks (RRs) were calculated using random effects models. A potential nonlinear dose-response relationship between BP and AD was tested using fractional polynomial models, and the best-fitting second-order fractional polynomial regression model was determined.Results: In the J-SHC Study and UK Biobank, there were 84 and 182 ADs during 4- and 9-year follow-up, and the adjusted HRs of AD were 3.57 (95% CI, 2.17-6.11) and 2.68 (95% CI: 1.78-4.04) in hypertensive individuals, 1.33 (95% CI: 1.05-1.68) and 1.27 (95% CI: 1.11-1.48) per 20-mmHg increase in systolic BP (SBP), and 1.67 (95% CI: 1.40-2.00) and 1.66 (95% CI: 1.46-1.89) per 10-mmHg increase in diastolic BP (DBP), respectively. In the meta-analysis, the summary RRs were 3.07 (95% CI 2.15-4.38, I2=76.7%, n=7 studies, 2,818 ADs, 4,563,501 participants) for hypertension and 1.39 (95% CI: 1.16-1.66, I2=47.7%, n=3) and 1.79 (95% CI: 1.51-2.12, I2=57.0%, n=3) per 20-mmHg increase in SBP and per 10-mmHg in DBP, respectively. The AD risk showed a strong, positive dose-response relationship with SBP and even more so with DBP. The risk of AD in the nonlinear dose-response analysis was significant at SBP >132 mmHg and DBP >7
AU  - Hibino,M
AU  - Otaki,Y
AU  - Kobeissi,E
AU  - Pan,H
AU  - Hibino,H
AU  - Taddese,H
AU  - Majeed,Z
AU  - Verma,S
AU  - Konta,T
AU  - Yamagata,K
AU  - Fujimoto,S
AU  - Tsuruya,K
AU  - Narita,I
AU  - Kasahara,M
AU  - Shibagaki,Y
AU  - Iseki,K
AU  - Moriyama,T
AU  - Kondo,M
AU  - Asahi,K
AU  - Watanabe,T
AU  - Watanabe,T
AU  - Watanabe,M
AU  - Aune,D
DO  - 10.1161/CIRCULATIONAHA.121.056546
EP  - 644
PY  - 2022///
SN  - 0009-7322
SP  - 633
TI  - Blood pressure, hypertension and the risk of aortic dissection incidence and mortality: results from the Japan-specific health checkups study, the UK biobank study and a metaanalysis of cohort studies
T2  - Circulation
UR  - http://dx.doi.org/10.1161/CIRCULATIONAHA.121.056546
UR  - https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.056546
UR  - http://hdl.handle.net/10044/1/92828
VL  - 145
ER  -

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