Relationships between statins and risk reduction of aortic dissection in patients with hypertension

Abstract

Purpose Statins have cardiovascular protective effects in addition to lipid-lowering effects. However, no human studies have examined whether statins prevent aortic dissection. This study aimed to explore the association between statins and aortic dissection. Methods This nested case–control study was based on data extracted from the UHDATA (Hypertension Database at Urumchi) in Xinjiang of China. Cases (patients who developed aortic dissection) and controls (patients without aortic dissection; matched for age, sex, and date of aortic dissection diagnosis) were selected from among the 52,146 adult patients with hypertension and hyperlipidemia or high-risk hypertension registered in the database between January 1, 2006, and December 31, 2018. Follow-up data were collected up to April 30, 2022. Multivariable logistic regression analysis was used to assess the relationship between statin use and aortic dissection. Results A total of 7049 patients (75.6% men; mean age, 54.6 years) were selected for the study: 647 patients who developed aortic dissection during the follow-up period and 6402 patients who did not develop aortic dissection. The proportion of patients using statins was higher in the case group than in the control group (21.2% vs. 29.9%, P < 0.001). However, in multivariable logistic regression analysis, statin use was independently associated with decreased risk for aortic dissection (adjusted OR = 0.538, 95% CI: 0.418–0.692, P < 0.001). Conclusions Statins appear to reduce risk of aortic dissection, and clinicians should consider early use of statins in hypertensive patients, especially those with hyperlipidemia and multiple risk factors.