Background: Aortic dilations (ectasies and aneurysms) may occur on any segment of the aorta.
Pathogenesis varies between locations, suggesting that etiology and risk factors may differ. In
spite of this discrepancy, guidelines recommend screening of the whole aorta if one segmental
dilation is discovered.
Objectives: To determine the most dominant predictors for dilations at the ascending, arch,
descending, and abdominal part of the aorta, and to establish comprehensive risk factor profiles
for each aortic segment.
Methods: Individuals aged 60-74 years were randomly selected to participate in the
cardiovascular screening trials DANCAVAS I+II. Participants underwent cardiovascular risk
assessments including blood samples, blood pressures, medical records, and non-contrast CTscans. Adjusted odds ratios (aOR) for potential risk factors of dilations were estimated by
multivariate logistic analyses.
Results: The study-population consisted of 14,989 participants (14,235 males, 754 females) with
an average age of 68 ±4 years. The highest aORs were observed when co-existing aortic dilations
were present. Other noteworthy predictors included co-existing iliac dilations, hypertension,
increasing body surface area, male sex, familial disposition, and atrial fibrillation, which were
present in various combinations for the different aortic parts. Smoking and acute myocardial
infarction were inversely associated with ascending and abdominal dilations. Diabetes was a
shared protective factor.
Conclusions: Risk factors differ for aortic dilations between locations. The most dominant
predictor for having a dilation at any aortic segment is the presence of an aortic dilation
elsewhere. This supports current guidelines when recommending a full screening of the aorta if a
focal aortic dilation is discovered.