Clinical characteristics of non-hypertension patients with acute aortic dissection

Abstract

Objective To investigate the clinical characteristics of no-hypertension patients with acute aortic dissection(AD). Methods Between January 2007 and December 2015, 1 220 patients with diagnosis of AD were hospitalized in Xijing Hospital of Air Force Medical University.These patients were divided into two groups: hypertension group(906 cases, 74.3%)and non-hypertension group(314 cases, 25.7%). The patients′ general data, clinical feature and mortality were compared and the difference between the two groups were analyzed. Results Epidemiologic factors: non-hypertensive patients were younger [(47.1±11.3)years vs.(50.7±10.2)years], Stanford type A AD(72.0%)were in the majority, and more male than female(71.7% vs. 28.3%), rural patients more than urban(67.8% vs. 32.2%). Clinical index: the in-hospital mortality was not significantly difference between the non-hypertension and hypertension patients(P=0.45). Compared with hypertension group, the proportion of heart function decreased, left ventricular enlarged, with pericardial effusion and carotid artery involvement were significantly higher in non-hypertension patients, as well as the diameter of ascending aorta and aortic sinus significantly widened(all P<0.05). However, the incidence of aorta with thrombus, branches of the abdominal aorta involvement or renal function decreased(creatinine and blood urea nitrogen)and abnormal fibrin degradation products(FDP)were less in non-hypertension group than in hypertension group(all P<0.05). Conclusions Clinical features are significantly difference in AD patients with and without hypertension.The former on age of onset is younger, mostly male and rural patients.The risk of vascular involvement in heart, brain is increased significantly.Simultaneously, the diameter of ascending aorta and aortic sinus significantly widened in non-hypertension, promoting the pathogenesis of non-hypertensive AD patients may be associated with abnormal aortic wall development. Key words: Aneurysm, dissecting; Hypertension; Disease attributes