Polymyalgia rheumatica (PMR) is characterized by musculotendinous inflammation around the shoulder and hip joints, leading to pain, stiffness, functional impairment, and worsened health-related quality of life [1]. Giant cell arteritis (GCA) is a large vessel vasculitis that has been associated with an increased risk of vascular complications (i.e., aortic aneurysm, dissection and/or rupture). PMR is reported in 40–60 % of patients with GCA [2], and 16–21 % of people with PMR may develop GCA, either at presentation or during follow-up [3]. Other common features of PMR and GCA include an overlapping age distribution, similar involved cytokines, and recent successful trials of therapies targeting the interleukin-6 pathway. Recent studies using large vessel imaging have also identified large vessel inflammation in 9 %−29 % of patients with isolated PMR [[4], [5], [6], [7]], leading many to suggest that these diseases exist as a “GCA-PMR Spectrum Disease [8].”

Though large vessel complications have been well-described for patients with GCA, whether or not this affects those with PMR is unknown. In GCA, aortic aneurysm and/or aortic dissection occur in approximately 20 patients per 1,000 person-years of follow-up [9,10]. Recognizing this, the American College of Rheumatology (ACR) and Vasculitis Foundation (VF) guides for the management of GCA recommend screening for large vessel involvement at time of GCA diagnosis [11]. The risk of aortic complications among patients with PMR is less adequately defined, and guidelines to date have not addressed this issue. Consequently, the risk of large vessel complications among patients with PMR represents an important area of clinical research. The objective of this study is to describe the incidence of aortic aneurysm and aortic dissection or rupture (referred to as “aortic complications”) in a large and nationally representative study of patients with GCA or PMR as well as a comparator group derived from a general population cohort.