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Admission blood pressure and mortality in acute aortic dissection: Southwest China multicenter retrospective cohort study
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  • Published: 09 March 2026

Admission blood pressure and mortality in acute aortic dissection: Southwest China multicenter retrospective cohort study

  • Yi Chen  ORCID: orcid.org/0009-0006-7614-83371 na1,
  • Xingxing Peng2 na1,
  • Qingwei Ji1,
  • Xinru Su3,
  • Ling Liu1,
  • Lin Su4,
  • Ning Chen1,
  • Lingmi Zhou5,6 &
  • …
  • Xiangwei Li1 

Scientific Reports , Article number:  (2026) Cite this article

  • 554 Accesses

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We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Subjects

  • Risk factors
  • Valvular disease

Abstract

The combined effect of admission systolic (SBP) and diastolic blood pressure (DBP) on short- and long-term all-cause mortality in patients with acute aortic dissection (AAD) remains insufficiently characterized. This retrospective cohort study investigated these associations to identify potential blood pressure thresholds linked to minimized mortality risk. We utilized restricted cubic splines (RCS) to characterize nonlinear associations, identifying specific BP levels (nadirs) associated with the lowest risk of mortality. Segmented analysis was employed to assess linear relationships flanking these nadirs, and multivariable Cox regression models were applied to evaluate the impact of different BP ranges after adjusting for potential confounders. Our results revealed a significant J-shaped correlation for admission SBP and DBP regarding long-term mortality. Mortality risks escalated at SBP levels departing from a nadir of 143.4 mmHg and at DBP departing from 83.7 mmHg. Specifically, an admission SBP/DBP range of 130–160/80–88 mmHg was associated with the lowest long-term all-cause mortality risk, serving as the risk-nadir interval in this cohort. Other independent predictors of mortality included advanced age, myocardial infarction, higher heart rate, history of heart bypass, elevated NT-proBNP and hsTNT, while type B AAD, normal heart rhythm and surgery within 24 h were protective factors. In conclusion, admission SBP and DBP exhibit significant nonlinear associations (J-shaped) with long-term all-cause mortality in AAD. The identified 130–160/80–88 mmHg range represents a potential reference interval for admission hemodynamic management, while acknowledging the need for validation in diverse clinical settings.

Data availability

The data that support the findings of this study are not publicly available due to their containing information that could compromise the privacy of research participants but are available from the first author Y.C., [chenyi1109@126.com](mailto: chenyi1109@126.com) upon reasonable request.

Abbreviations

HTN:

Hypertension

RBC:

Red blood cell

HB:

Hemoglobin

WBC:

White blood cell

NE:

Neutrophils

Lym:

Lymphocyte

FPG:

Fasting plasma glucose

TG:

Triglycerides

TC:

Total cholesterol

HDLC:

High-density lipoprotein cholesterol

LDLC:

Low-density lipoprotein cholesterol

Cr:

Creatinine

UA:

Uric acid

CRP:

C-Reactive protein

NTproBNP:

N-terminal pro-B-type natriuretic peptide

hsTNT:

High-sensitivity troponin T

LVEF:

Left ventricular ejection fraction

LVD:

Left ventricular end-diastolic diameter

IMH:

Intramural hematoma

IRAD:

International register of acute aortic dissection

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Acknowledgements

We extended our heartfelt gratitude to the committed personnel at the Affiliated Hospital of Guilin Medical University in Guilin and the People’s Hospital of Guangxi Zhuang Autonomous Region in Nanning, Guangxi, China, for their essential role in the precise and diligent gathering of data.

Funding

This work was supported by the Scientific Research Project of Health Commission of Guangxi Zhuang Autonomous Region (Z-A20230040); Guangxi Science and Technology Base and Special Talents’ Project (GK AD17129026); Guangxi Science and Technology Specialized Project (GKG 14124003-9); Fund Project of Guangxi Zhuang Autonomous Region Health Commission (S2020116-1) and Guangxi Medical and health key cultivation discipline construction project. The funders had no role in the study design, data collection, analysis, interpretation, or writing of the manuscript.

Author information

Author notes

  1. These authors contributed equally: Yi Chen and Xingxing Peng.

Authors and Affiliations

  1. The People’s Hospital of Guangxi Zhuang Autonomous Region and Guangxi Academy of Medical Sciences, Nanning, 530021, China

    Yi Chen, Qingwei Ji, Ling Liu, Ning Chen & Xiangwei Li

  2. Department of Cardiovascular Surgery, The First Affiliated Hospital of Guilin Medical University, Guilin, 541001, Guangxi, China

    Xingxing Peng

  3. Guangxi University of Chinese Medicine, Nanning, 530200, China

    Xinru Su

  4. Guangxi Medical University Cancer Hospital, Guilin, 541199, China

    Lin Su

  5. Guilin Medical University, Guilin, 541199, China

    Lingmi Zhou

  6. Guangxi Key Laboratory of Environmental Exposure Omics and Life Cycle Health, Guilin, 541199, China

    Lingmi Zhou

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Contributions

Y.C., QW. J and XW.L. were responsible for study design and planning. XR.S. , XX.P. , N.C. and L.S. contributed to data collection and cleaning. Y.C., LM.Z. and XR.S. contributed to data analysis. Y.C. and XX.P. contributed to writing the original report. QW.J., XW.L. and L.L. contributed to writing-review and editing. All authors read and approved the final version of the article.

Corresponding authors

Correspondence to Lingmi Zhou or Xiangwei Li.

Ethics declarations

Competing interests

The authors declare no competing interests.

Ethical approval

The current study was a retrospective study, the nursing follow-up was conducted by staff out of our study team, the personal information for patients was de-identified after data extraction, so no direct patient was involved in this research. Therefore, informed consent from each participant was waived. The waiver of informed consent for the study was approved by the Research Ethics Committee at the People’s Hospital of Guangxi Zhuang Autonomous Region, China (IRB-KY-ZC-2023-049). This study protocol was reviewed and approved by the Research Ethics Committee at the People’s Hospital of Guangxi Zhuang Autonomous Region, China (IRB-KY-ZC-2023-049) as well.

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Cite this article

Chen, Y., Peng, X., Ji, Q. et al. Admission blood pressure and mortality in acute aortic dissection: Southwest China multicenter retrospective cohort study. Sci Rep (2026). https://doi.org/10.1038/s41598-026-43101-x

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  • Received: 17 March 2025

  • Accepted: 02 March 2026

  • Published: 09 March 2026

  • DOI: https://doi.org/10.1038/s41598-026-43101-x

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Keywords

  • Acute aortic dissection
  • Systolic blood pressure
  • Diastolic blood pressure
  • All-cause mortality
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