Abstract
BACKGROUND: Hypertension and smoking are well-known risk factors for aortic dissection (AD), but it is unclear whether other lifestyle factors influence the risk. The aim of this study was to investigate the association between diet quality, physical activity, and risk of AD. METHODS: The study included 28,094 participants from the Malmö Diet and Cancer Study, recruited between 1991 and 1996 and followed through national health registers until 31 December 2022. Diet quality was assessed using a six-component Diet Quality Index. Incident AD was identified through ICD-9/ICD-10 codes in the Swedish National Patient Register. Associations were analyzed using Cox proportional hazards models. RESULTS: During a median follow-up of 26.6 years, 130 participants developed AD. Higher age (HR 1.76/one standard deviation increment, 95% CI 1.41-2.20), male sex (HR 1.58, 95% CI 1.06-2.34), hypertension (HR 1.57, 95% CI 1.01-2.44), and current smoking (HR 3.04, 95% CI 1.86-4.98) were each independently associated with increased AD risk. No significant associations were found for diet quality and physical activity with AD risk. CONCLUSIONS: No associations were found between diet quality and physical activity and AD risk. Blood pressure control and smoking cessation are key preventive measures to reduce incidence of AD.