PAEA Surgery End Of Rotation (EOR) Practice Exam

What is the leading risk factor for aortic dissections?

1. Smoking

2. Hypertension

3. Diabetes mellitus

4. Hyperlipidemia

The correct answer is: Hypertension

Hypertension is recognized as the leading risk factor for aortic dissections due to its role in increasing the stress on the aortic wall. When blood pressure is chronically elevated, it can lead to the weakening of the aortic media, making it more susceptible to tearing. The increased hemodynamic forces associated with high blood pressure can precipitate the initiation of a dissection, where a tear forms in the intimal layer of the aorta, allowing blood to flow between the layers of the vessel wall. Other risk factors, such as smoking, diabetes mellitus, and hyperlipidemia, can contribute to cardiovascular disease but are not as directly linked to the specific pathophysiology of aortic dissections. Smoking can damage blood vessels and exacerbate hypertension, while diabetes and hyperlipidemia are more related to atherosclerosis, which is a different disease process. Understanding these dynamics helps clarify why hypertension stands out as the primary risk factor in the context of aortic dissections.