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Association of renal cyst and type A acute aortic dissection with hypertension

Jinlan Bao1, Shaoxin Zheng1, Canxia Huang2

  • 1Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.

Journal of Thoracic Disease
|January 15, 2021
PubMed

Insights

Renal cysts are linked to increased risk of Type A acute aortic dissection (TA-AAD) in hypertensive patients, particularly in older individuals. Tailored antihypertensive strategies based on renal cyst status may improve prevention.

Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Vascular Surgery

Background:

  • Type A acute aortic dissection (TA-AAD) carries a high mortality rate, often exceeding 50% before hospital admission.
  • Hypertension is a primary comorbidity, yet current antihypertensive therapies do not reliably predict long-term aortic rupture risk.
  • The association between renal cysts and TA-AAD in hypertensive individuals is not well-established, despite renal cysts increasing thoracic aortic disease risk.

Purpose of the Study:

  • To investigate the relationship between the presence and number of renal cysts and the risk of TA-AAD in patients with hypertension.
  • To determine if renal cyst status modifies the risk of TA-AAD in hypertensive individuals across different age groups.

Main Methods:

  • A retrospective analysis of 464 hypertensive patients (August 2014 - August 2019).
  • 230 TA-AAD patients were matched with 234 non-TA-AAD controls based on age, sex, and hypertension control.
  • Patients were stratified into subgroups: no renal cyst, single renal cyst, and multiple renal cysts.

Main Results:

  • The TA-AAD group exhibited a higher prevalence of single and multiple renal cysts compared to the control group.
  • Multivariate analysis revealed that having no renal cyst significantly reduced TA-AAD risk in middle-aged and elderly patients.
  • Single renal cyst status was associated with a decreased risk of TA-AAD specifically in elderly patients (OR=0.129, P=0.007).

Conclusions:

  • Renal cyst status is a significant correlate of TA-AAD risk in hypertensive middle-aged and elderly individuals.
  • The presence and number of renal cysts appear to influence the extent of vascular lesions in aortic dissection.
  • Personalized antihypertensive management tailored to individual renal cyst status is recommended for more effective aortic dissection prevention.
Abstract

Keywords:
Type A acute aortic dissection (TA-AAD)hypertensionrenal cyst

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