Which client is considered at the highest risk for a dissecting aneurysm?

A dissecting aneurysm is a serious condition where there is a tear in the artery wall which can lead to potentially life-threatening complications. Certain risk factors make some individuals more susceptible to developing this condition.

Individuals with uncontrolled hypertension are at a significantly higher risk for dissecting aneurysms. This is primarily due to the increased pressure exerted on the arterial walls, which can weaken them and make them more prone to tearing. In the case of the client who is a 55-year-old black male with uncontrolled hypertension, the presence of hypertension is a key contributor to the risk of dissection. Moreover, age plays a role, as the risk increases with advancing years.

The other clients listed have risk factors that may contribute to other cardiovascular issues or aneurysm types, but they do not carry the same level of risk for dissecting aneurysms specifically. For instance, controlled hypertension in the first scenario mitigates this risk, while smoking is a significant risk factor for many vascular diseases, it does not directly correlate with dissecting aneurysms to the same extent as uncontrolled hypertension. Diabetes, while it can lead to other vascular complications, also does not elevate the risk for dissecting aneurysms as directly as uncontrolled hypertension does.

Therefore, the combination of