What is considered the most significant risk factor for developing an aortic dissection?

Hypertension, or high blood pressure, is the most significant risk factor for developing an aortic dissection. This condition arises when there is a tear in the inner layer of the aorta, allowing blood to flow between the layers of the artery wall. Persistent high blood pressure can exert increased stress on the aortic wall, promoting the potential for such tears to occur.

Individuals with chronic hypertension often have structural changes in the arterial wall, including increased stiffness and changes to collagen and elastin fibers, which can weaken the aortic wall and predispose it to dissection. This relationship between hypertension and aortic dissection has been well-established in medical literature, making it a critical point for recognition and management in patients with cardiovascular issues.

While other factors like male sex, age, and high cholesterol can contribute to the overall risk of cardiovascular disease, they are not as directly linked to the mechanism of aortic dissection as hypertension. Male sex and age are associated with the prevalence of cardiovascular conditions but do not specifically address the underlying pathophysiology of an aortic dissection in the same manner that hypertension does. High cholesterol primarily affects atherogenesis rather than directly causing the tearing of the aortic wall that defines dissection.