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Original research
Sex-specific distributions and determinants of thoracic aortic diameters in the elderly
  1. Lidia R Bons1,2,
  2. Oscar L Rueda-Ochoa3,4,
  3. Khalid El Ghoul1,
  4. Sofie Rohde1,
  5. Ricardo PJ Budde2,
  6. Maarten JG Leening1,3,5,
  7. Meike W Vernooij2,3,
  8. Oscar H Franco3,6,
  9. Aad van der Lugt2,
  10. Jolien W Roos-Hesselink1,
  11. Maryam Kavousi3,
  12. Daniel Bos2,3,5
  1. 1 Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
  2. 2 Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
  3. 3 Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
  4. 4 Electrocardiography Research Group, School of Medicine, Universidad Industrial de Santander, Bucaramanga, Santander, Colombia
  5. 5 Department of Clinical Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
  6. 6 Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
  1. Correspondence to Dr Jolien W Roos-Hesselink, Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam 3015CN, The Netherlands; j.roos{at}


Objective To provide population-based distributions of thoracic aortic diameters in men and women aged 55 years or older and to identify determinants of thoracic aortic diameters.

Methods From 2003 to 2006, 2505 participants (1208 men, mean age 69.1±6.8 years) from the prospective population-based Rotterdam Study underwent non-enhanced cardiac CT. The diameter of the ascending (AA) and descending aorta (DA) was measured at the level of the pulmonary bifurcation.

Results The mean diameter of the ascending and descending aorta was substantially larger in men (38±4 mm and 30±2 mm) than in women (35±3 mm and 27±2 mm). An ascending aortic diameter of larger than 40 mm was found in 228 (18.9%) men and 76 (5.9%) women and a descending aortic diameter larger than 40 mm was found in two men and no women. Male sex was found to be independently associated with larger DA diameter (standardised β 0.24, 95% CI 0.19 to 0.30), while a statistically non-significant trend was found for the AA diameter (standardised β 0.06, 95% CI 0.00 to 0.12). Age, height, weight and traditional cardiovascular risk factors were also associated with larger AA and/or DA diameters. Diabetes was associated with smaller AA and DA diameters. We found no evidence for effect modification by sex.

Conclusions In persons aged 55 years or older, an ascending aortic diameter of 40 mm or larger was found in 18.9% of men and 5.9% of women. Given the importance of sex, sex-specific distribution values may prove useful in clinical practice, even when correcting for body surface area or height.

  • aortic aneurysm
  • epidemiology
  • cardiac computer tomographic (CT) imaging
  • cardiac risk factors and prevention

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  • LRB and OLR-O are joint first authors.

  • JWR-H, MK and DB shared last authorship.

  • Contributors LRB, OLR-O, DB, MK, OHF, AvdL and JWR-H contributed to the concept/design, data analysis/interpretation and drafting of the article. KE and SR contributed to data collection and writing. MV, MJGL and RB contributed to the concept/design, critical revision of the article and approval of the article. JWR-H, MK and DB shared last authorship.

  • Funding The Rotterdam Study is funded by Erasmus MC and Erasmus University, Rotterdam, the Netherlands; the Netherlands Organisation for Scientific Research (NWO); the Netherlands Organisation for Health Research and Development (ZonMw); the Research Institute for Diseases in the Elderly (RIDE); the Ministry of Education, Culture and Science; the Ministry for Health, Welfare and Sports; the European Commission (DG XII); and the Municipality of Rotterdam. MK is supported by a VENI grant (91616079) from ZonMw. JWR-H and LRB are supported by the Dutch Heart Foundation (2013T093) and ZonMW (849200014). OLR-O is supported by COLCIENCIAS and Universidad Industrial de Santander, Colombia.

  • Disclaimer The funding organisations had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; or decision to submit the manuscript for publication.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request.

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