The Relationship Between High Blood Pressure and the Occurrence of Aortic Aneurysm Rupture; Case control study in Saraburi hospital.
Abstract
Introduction Aortic dissection is a medical emergency condition with a high mortality rate if left untreated. Among patients with aortic dissection, a major risk factor is high blood pressure, which can be managed. By controlling high blood pressure, the incidence of aortic dissection can be reduced.
Objectives The research conducted at Saraburi Hospital aims to study the correlation between high blood pressure levels and the occurrence of aortic dissection when compared to individuals with hypertension possessing similar baseline characteristics.
Method A matched case-control study was conducted to investigate patients admitted to Saraburi Hospital’s emergency room due to aortic dissection between January 2011 and December 2020. The research compared blood pressure data among hypertensive patients in Saraburi Hospital’s hypertension clinic during the same period. These patients were paired with a control group based on baseline characteristics, such as gender, age range, blood pressure records from 5 years before aortic dissection diagnosis, smoking habit, diabetes, hyperlipidemia, stroke, coronary heart disease, and regular medications.
Result In total, 175 patients participated in the study, divided into two groups: 35 patients with aortic dissection and 140 individuals in the control group. The findings revealed that the blood pressure levels of the aortic dissection group on the day of diagnosis were significantly higher than those of the control group [Adjusted odds ratio (AOR): 1.04, 95% CI: 1.01-1.08, p-value < 0.010]. When comparing blood pressure levels on the day of diagnosis between the case group and the control group, it was statistically significant that the case group had a significantly higher diagnosis of hypertensive emergencies than the control group. [Odd ratio (OR): 49.16, 95%CI: 6.95-347.18, p-value < 0.010])
Conclusion Management of elevated blood pressure levels and hypertensive emergencies, particularly the reduction of systolic blood pressure, can help reduce the occurrence of aortic dissection at the Saraburi hospital.
Keywords Aortic dissection, Hypertension, Controlling high blood pressure, Blood pressure category, Hypertensive crisis
References
Pisudtinontakul W, Chittithavorn V. Management of Thoracic aortic dissection type A [Internet]. Department of surgery, Prince of Songkla University; 2011 [cited 2021 Dec 22]. Available from: http://medinfo2.psu.ac.th/surgery/Collective%20review/2554/2.Management_of_thoracic_Aortic_dissection_type_A%20(Warut%2013.7.54).pdf
Olin JW, Fuster V. Acute Aortic Dissection: The Need for Rapid, Accurate, and Readily Available Diagnostic Strategies. Arterioscler Thromb Vasc Biol. 2003 Oct;23(10):1721–3.
DeMartino RR, Sen I, Huang Y, Bower TC, Oderich GS, Pochettino A, et al. Population-Based Assessment of the Incidence of Aortic Dissection, Intramural Hematoma, and Penetrating Ulcer, and Its Associated Mortality From 1995 to 2015. Circ Cardiovasc Qual Outcomes. 2018 Aug;11(8):1–12.
Rogers AM, Hermann LK, Booher AM, Nienaber CA, Williams DM, Kazerooni EA, et al. Sensitivity of the Aortic Dissection Detection Risk Score, a Novel Guideline-Based Tool for Identification of Acute Aortic Dissection at Initial Presentation: Results From the International Registry of Acute Aortic Dissection. Circulation. 2011 May 24;123(20):2213–8.
Mayo Clinic Staff. Aortic dissection [Internet]. Mayo Clinic. 2021 [cited 2021 Dec 25]. Available from: https://www.mayoclinic.org/diseases-conditions/aortic-dissection/symptoms-causes/syc-20369496
Kinney-Ham L, Nguyen HB, Steele R, Walters E. Acute Aortic Dissection in Third Trimester Pregnancy without Risk Factors. West J Emerg Med. 2011;12(4):571–4.
Juang D, Braverman AC, Eagle K. Aortic Dissection. Circulation [Internet]. 2008 Sep 30 [cited 2021 Dec 28];118(14). Available from: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.108.799908
Abbass A, D’Souza J, Asad-Ur-Rahman F, Khalid S. Abstract 14473: Aortic Dissection in Association With Liddle Syndrome. Circulation [Internet]. 2016 Nov 11 [cited 2021 Dec 28];134. Available from: https://doi.org/10.1161/circ.134.suppl_1.14473
Takeuchi T, Adachi H, Ohuchida M, Nakamura T, Satoh A, Jacobs DR, et al. A case–control study found that low albumin and smoking were associated with aortic dissection. J Clin Epidemiol. 2004 Apr;57(4):386–91.
Evangelista A, Co-Director, Department of Cardiac Imaging, Hospital Vall d’Hebron, Barcelona. E: aevangelistam@medynet.com. Insights from the International Registry of Acute Aortic Dissection – What Have We Learned? Eur Cardiol Rev. 2008;4(1):79.
Howard DPJ, Banerjee A, Fairhead JF, Perkins J, Silver LE, Rothwell PM. Population-Based Study of Incidence and Outcome of Acute Aortic Dissection and Premorbid Risk Factor Control: 10-Year Results From the Oxford Vascular Study. Circulation. 2013 May 21;127(20):2031–7.
Thai Hypertension Society. 2019 Thai Guidelines on The Treatment of Hypertension [Internet]. 1st ed. Bangkok; 2019. Available from: http://www.thaihypertension.org/files/HT%20guideline%202019.with%20watermark.pdf
Wall HK, Hannan JA, Wright JS. Patients With Undiagnosed Hypertension: Hiding in Plain Sight. JAMA. 2014 Nov 19;312(19):1973.
Levy D, Goyal A, Grigorova Y, Farci F, Le JK. Aortic Dissection. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2023 Nov 1]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK441963/
Homan TD, Bordes SJ, Cichowski E. Physiology, Pulse Pressure. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2023 Nov 1]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK482408/
Cernes R, Zimlichman R, Shargorodsky M. Arterial Elasticity in Cardiovascular Disease: Focus on Hypertension, Metabolic Syndrome and Diabetes. In: Fisman EZ, Tenenbaum A, editors. Advances in Cardiology [Internet]. Basel: KARGER; 2008 [cited 2021 Dec 29]. p. 65–81. Available from: https://www.karger.com/Article/FullText/115188
Otaki Y, Watanabe T, Konta T, Watanabe M, Fujimoto S, Sato Y, et al. One-Year Change in Diastolic Blood Pressure and Aortic Disease-Related Mortality in a Japanese General Population Aged 50–75 Years. Circ J. 2021 Nov 25;85(12):2222–31.
Mészáros I, Mórocz J, Szlávi J, Schmidt J, Tornóci L, Nagy L, et al. Epidemiology and Clinicopathology of Aortic Dissection. Chest. 2000 May;117(5):1271–8.
Gao Y, Li D, Cao Y, Zhu X, Zeng Z, Tang L. Prognostic value of serum albumin for patients with acute aortic dissection: A retrospective cohort study. Medicine (Baltimore). 2019 Feb;98(6):1–7.
Isselbacher EM, Preventza O, Hamilton Black J, Augoustides JG, Beck AW, Bolen MA, et al. 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Circulation [Internet]. 2022 Dec 13 [cited 2023 Nov 1];146(24). Available from: https://www.ahajournals.org/doi/10.1161/CIR.0000000000001106
Wong GW, Laugerotte A, Wright JM. Blood pressure lowering efficacy of beta-1 selective beta blockers for primary hypertension. In: The Cochrane Collaboration, editor. Cochrane Database of Systematic Reviews [Internet]. Chichester, UK: John Wiley & Sons, Ltd; 2008 [cited 2023 Nov 1]. p. CD007451. Available from: https://doi.wiley.com/10.1002/14651858.CD007451
![1](https://he01.tci-thaijo.org/public/journals/820/submission_270957_57476_coverImage_en_US.jpg)
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Ravipol Jurjai
![Creative Commons License](http://i.creativecommons.org/l/by-nc-nd/4.0/88x31.png)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Journal of TCI is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) licence, unless otherwise stated. Please read our Policies page for more information.