No abstract

Background-Acute aortic dissection is a preventable life-threatening condition. However, there have been no prospective population-based studies of incidence or outcome to inform an understanding of risk factors, strategies for prevention, or projections for future clinical service provision. Prospective population-based ascertainment showed that hospital-based registries will underestimate not only incidence and case fatality, but also the association with premorbid hypertension.

Conclusions: Hospital-based registries likely underestimate not only the incidence of acute aortic dissection but also its association with premorbid hypertension. The most significant treatable condition leading to acute aortic dissection remains uncontrolled hypertension.Summary: Even with well-established treatment guidelines, acute aortic dissection can have a high case fatality rate. However, little data on risk factors, incidence, or outcome of acute aortic dissection are available, and there is no prospective population-based study. Although abdominal aortic aneurysm incidence of rupture appears to be declining (Darwood R et al, J Vasc Surg 2012;56:8-13), trends with respect to acute aortic dissection are uncertain (Thrumurthy SG et al, BMJ 2012;344:d8290). The authors note there have only been two studies of the epidemiology of aortic dissection since 1980, and both were retrospective and used only routinely collected diagnostic or mortality coding data. Neither study assessed premorbid risk factors or functional outcome (

Delays to carotid imaging and endarterectomy after TIA or stroke in the United Kingdom are similar to those reported in several other countries and are associated with very high risks of otherwise preventable early recurrent stroke.