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However, validated prediction models for these conditions remain scarce. We developed risk prediction models for AD, AA, and PAD using routine health check-up data. We used data from the DeSC database, encompassing 1,082,369 participants aged 20\u201374 years without prior cardiovascular disease for model derivation. Study participants were randomly split into derivation (50%) and internal validation (50%) cohorts. The primary outcomes were the incidence of AD, AA, and PAD. Flexible parametric survival models were used to estimate 5-year risk using routine health check-up data, including age, sex, body mass index, blood pressure, lipid profile, glucose, smoking status, physical activity, and medication use. During follow-up, 756 AD, 2,230 AA, and 4,131 PAD events occurred. In the internal validation cohort, Harrell\u2019s C-index was 0.781 (95% confidence interval: 0.761 to 0.801) for AD, 0.812 (0.799 to 0.825) for AA, and 0.701 (0.690 to 0.711) for PAD. The Royston D statistic was 1.695 (1.533 to 1.857) for AD, 1.975 (1.874 to 2.075) for AA, and 1.222 (1.152 to 1.292) for PAD. The models had good calibration for each outcome. Risk prediction equations were developed and validated to estimate risk for the development of AD, AA, and PAD based on routine health check-up data. These models may allow risk stratification to support earlier diagnosis and intervention for vascular disease. Further external validation using datasets from different target populations and clinical settings is warranted.<\/jats:p>","DOI":"10.1038\/s41440-026-02730-5","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T08:27:46Z","timestamp":1784017666000},"page":"2499-2509","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prediction model for aortic dissection, aortic aneurysm, and peripheral artery disease"],"prefix":"10.1038","volume":"49","author":[{"given":"Yuta","family":"Suzuki","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidehiro","family":"Kaneko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Okada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiyuki","family":"Ko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Jimba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Mizuno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsuhito","family":"Fujiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Morita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norifumi","family":"Takeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichi","family":"Node","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideo","family":"Yasunaga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norihiko","family":"Takeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"2730_CR1","doi-asserted-by":"publisher","first-page":"1837","DOI":"10.1161\/01.CIR.97.18.1837","volume":"97","author":"PW Wilson","year":"1998","unstructured":"Wilson PW, D\u2019Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. 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Eur Heart J Acute Cardiovasc Care. 2021;10:701\u20139.","journal-title":"Eur Heart J Acute Cardiovasc Care"}],"container-title":["Hypertension Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41440-026-02730-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41440-026-02730-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41440-026-02730-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T22:03:35Z","timestamp":1788732215000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41440-026-02730-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,14]]},"references-count":48,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["2730"],"URL":"https:\/\/doi.org\/10.1038\/s41440-026-02730-5","relation":{},"ISSN":["0916-9636","1348-4214"],"issn-type":[{"value":"0916-9636","type":"print"},{"value":"1348-4214","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,14]]},"assertion":[{"value":"18 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 June 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 June 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 July 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Toshiyuki Ko is a member of the Frontier Cardiovascular Science, a cooperative program between the University of Tokyo and Boehringer Ingelheim, and has received research grants from Daiichi Sankyo and Takeda. Research funding and scholarship funds from Medtronic Japan CO., LTD, Boston Scientific Japan CO., LTD, Biotronik Japan, and Simplex QUANTUM CO., LTD (Hidehiro Kaneko and Katsuhito Fujiu). Hidehiro Kaneko holds shares in PrevMed Co., Ltd. and Japan Preventive Medicine Development Institute Co., Ltd. Akira Okada is a member of the Department of Prevention of Diabetes and Lifestyle-related Diseases, a cooperative program between the University of Tokyo and the Asahi Mutual Life Insurance Company. Koichi Node has received honoraria from Novartis, Novo Nordisk, Mochida, Otsuka, Daiichi Sankyo; research grants from Fuji Yakuhin, Novartis Pharma, Bayer Yakuhin, Mochida Pharmaceutical; scholarship from Boehringer Ingelheim Japan, Abbott Medical Japan.\u00a0The algorithm evaluated in this study is the subject of a pending patent application filed (Japanese Patent Application No. 2025-014571) by The University of Tokyo. The intellectual property has been licensed to Japan Preventive Medicine Development Institute Co., Ltd. Hidehiro Kaneko is a founder and shareholder of Japan Preventive Medicine Development Institute Co., Ltd. The University of Tokyo may receive royalties related to this license. All other authors declare no competing interests.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}}]}}