Aortic dissections are sometimes called dissecting aneurysms or dissecting hematomas. Acute aortic dissections are usually major catastrophic vascular events and have considerable morbidity and mortality, even with current methods of medical and surgical treatment. The current research considered all individuals who died from aortic dissections during 1987-96. The research focused on age, sex, race, medical and drug history, the circumstances of death, and autopsy findings. Twenty percent of the cases tested for drugs of abuse were positive for methamphetamine. One of these individuals was positive for both methamphetamine and the cocaine metabolite benzoylecgonine. However, results revealed no cases of dissection related only to cocaine. In addition, no significant association existed with any other drugs. The most common risk ractor was hypertension. Surprisingly, methamphetamine use was the second most common risk factor. The association between methamphetamine use and aortic dissection is mostly likely due to its hypertensive effect. Findings suggested that although methamphetamine appears to pose a greater risk than cocaine, both drugs should be considered possible factors in all aortic dissections. Tables, figures, and 25 references (Author abstract modified)