title: Clinical profiles and outcomes of acute aortic dissection in a predominantly Hispanic population.
abstract: BACKGROUND
  Acute aortic dissection (AAD) is a life-threatening cardiovascular condition with high morbidity and mortality. We sought to assess clinical profiles as well as outcomes of AAD in a predominantly Hispanic population and to explore the relationship between this condition and uncontrolled/untreated hypertension in this community.
  
  
  METHODS
  This was a single-center, retrospective, cross-sectional study of patients admitted with AAD over a 10 years period.
  
  
  RESULTS
  Fifty-nine cases of AAD were included in the analysis. The group of Hispanics with AAD had more females (48.3%, p=0.002), more dyslipidemia and coronary artery disease (p=0.006 and 0.05, respectively), and a tendency to be older and have more hypertension and diabetes compared to non-Hispanics. Although 70.2% of all patients had hypertension, only 52.5% of them were being treated; of those, only 66.7% achieved optimal blood pressure control prior to presentation. Only 47.4% received beta-blockers for blood pressure control in the acute setting. Longer length of in-hospital stay was associated with older age, higher troponin and creatine kinase levels, and presence of hypertension. In-hospital death occurred in 10 (17%) patients and mortality was significantly associated with higher serum creatinine (p=0.01).
  
  
  CONCLUSIONS
  Hispanic patients with AAD were more likely to be female, of older age, and have more cardiovascular risk factors in comparison to non-Hispanics. In addition, significant under-treatment of hypertension in this population and underutilization of beta-blockers for blood pressure control in the acute settings was evident. Better prevention and timely treatment may improve outcomes for this condition in this population.
authors.affiliation: Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, USA.
authors.forename: Haider
authors.initials: H
authors.lastname: Alkhateeb
authors.affiliation: Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, USA.
authors.forename: Sarmad
authors.initials: S
authors.lastname: Said
authors.affiliation: Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, USA.
authors.forename: Chad J
authors.initials: CJ
authors.lastname: Cooper
authors.affiliation: Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, USA.
authors.forename: Carlos
authors.initials: C
authors.lastname: Rodriguez-Castro
authors.affiliation: Department of Biomedical Sciences, Division of Biostatistics and Epidemiology, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, El Paso, USA.
authors.forename: Alok
authors.initials: A
authors.lastname: Dwivedi
authors.affiliation: Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, USA.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Onate
authors.affiliation: Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, USA.
authors.forename: Raphael
authors.initials: R
authors.lastname: Quansah
authors.affiliation: Department of Internal Medicine, Division of Cardiovascular Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, USA.
authors.forename: Debabrata
authors.initials: D
authors.lastname: Mukherjee
mesh_terms: D000208:Acute Disease; D000784:Aortic Dissection / Q000175:diagnosis* / Q000628:therapy*; D001014:Aortic Aneurysm / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D016896:Treatment Outcome