Hibino M, Otaki Y, Kobeissi E, et al. - A high risk of aortic dissection (AD) was observed in relation to hypertension and elevated systolic blood pressure (BP) [SBP] and diastolic BP [DBP]. A positively dose-dependent AD risk was noted, even within the normal BP range. These observations offer further evidence for the optimization of BP to avert AD.

• Data from the Japan Specific Health Checkups (J-SHC) Study and UK Biobank (which prospectively followed 534,378 and 502,424 participants, respectively) were used to determine the link between hypertension/elevated BP and AD.

• A meta-analysis was also conducted to calculate summary relative risks (RRs) by employing random effects models.

• A 4- and 9-year follow-up revealed 84 and 182 ADs in the J-SHC Study and UK Biobank, and the adjusted hazard ratios of AD were 3.57 and 2.68 in hypertensive people, 1.33 and 1.27 per 20-mmHg rise in SBP, and 1.67 and 1.66 per 10-mmHg elevation in DBP, respectively.

• Summary RRs from the meta-analysis were 3.07 for hypertension and 1.39 and 1.79 per 20-mmHg elevation in SBP and per 10-mmHg in DBP, respectively.

• There was a strong, positive dose-response association of AD risk with SBP and even more so with DBP.

• Significant AD risk was observed at SBP >132 mmHg and DBP >75 mmHg, in the nonlinear dose-response analysis.