Association analysis of blood pressure with incident risks for thoracic and abdominal aortic aneurysms: an observational study of the UK Biobank cohort.

Abstract

Background: The specific relationship between different blood pressure measures and the risk of aortic aneurysms (AA) remains unclear. Elucidating these associations would be conducive to identifying high-risk individuals and developing more effective screening strategies, potentially reducing AA incidence. This study aimed to investigate the association between various blood pressure measures or subtypes of hypertension and the risk of AA.

Methods: Using data from the UK biobank study, we performed multivariable Cox regression analysis to estimate HRs for baseline systolic blood pressure (SBP), diastolic blood pressure (DBP) and pulse pressure (PP) with risk of AA. The associations of isolated systolic hypertension, isolated diastolic and combined systolic-diastolic hypertension for AA were also assessed.

Results: Our analysis included 397 019 participants without antihypertensive medication at baseline (mean age, 55.4 (SD 8.1) years; 56.6% female). We identified 1782 cases of AA during a median follow-up period of 12 years. The association between SBP and AA was weak (per-SD HR=1.03, 95% CI 0.98 to 1.08). The association between DBP and AA (per-SD HR=1.24, 95% CI 1.15 to 1.33) was significant when DBP reached 80 mm Hg and higher. Lower PP was linearly associated with increasing AA risk (per-SD HR=0.76, 95% CI 0.69 to 0.83). These patterns were consistent when comparing abdominal AA with overall cases. Compared with the normal group, the HRs of isolated systolic hypertension, isolated diastolic hypertension and combined hypertension on AA were 1.01 (95% CI 0.89 to 1.13), 1.67 (95% CI 1.27 to 2.18) and 1.35 (95% CI 1.20 to 1.52), respectively.

Conclusions: Elevated DBP and reduced PP, but not SBP, were independently associated with a higher risk of incident AA, highlighting their potential to refine clinical risk stratification.