Which factors predict aortic dilations in older adults?

Predictors for ascending, arch, descending, and abdominal aortic dilations vary between locations, but the presence of an aortic dilation elsewhere is the most prevalent risk factor for having a dilation at any aortic segment, according to a study.

“This supports current guidelines when recommending a full screening of the aorta if a focal aortic dilation is discovered,” the authors said.

In this study, older adults aged 60–74 years were randomly chosen to participate in Danish Cardiovascular Multicenter Screening Trials I and II. Participants underwent cardiovascular risk evaluations, such as blood samples, blood pressure readings, medical records, and noncontrast computed tomography scans.

The authors estimated the adjusted odds ratios (ORs) for potential risk factors of dilations through multivariate logistic analyses.

A total of 14,989 participants (mean age 68±4 years, 14,235 men) were included in the study. The presence of coexisting aortic dilations was associated with the highest adjusted ORs for having any aortic dilation.

Other significant risk factors were as follows: coexisting iliac dilations, hypertension, increasing body surface area, male sex, familial disposition, and atrial fibrillation. These predictors presented in various combinations for the different aortic parts.

On the other hand, smoking and acute myocardial infarction inversely correlated with ascending and abdominal dilations. Diabetes was a shared protective factor.

“Aortic dilations (ectasias and aneurysms) may occur on any segment of the aorta. Pathogenesis varies between locations, suggesting that aetiology and risk factors may differ. Despite this discrepancy, guidelines recommend screening of the whole aorta if one segmental dilation is discovered,” the authors said.