Affiliation:
1. Clinical Trial Service Unit and Epidemiological Studies Unit Nuffield Department of Population Health University of Oxford United Kingdom
2. Department of Vascular and Endovascular Surgery The Townsville Hospital Queensland Australia
3. MRC Population Health Research Unit Nuffield Department of Population Health University of Oxford United Kingdom
4. Nuffield Department of Surgical Sciences University of Oxford United Kingdom
Abstract
Background
Large studies are required for reliable estimates of important risk factors for abdominal aortic aneurysm (
AAA
). This could guide targeted
AAA
screening programs, particularly in subgroups like women who are currently excluded from such programs.
Method and Results
In a cross‐sectional study, 1.5 million women and 0.8 million men without known vascular disease attended commercial screening clinics in the United Kingdom or United States from 2008 to 2013. Measurements of vascular risk factors were related to
AAA
using logistic regression with correction for regression dilution bias. Screening detected 12 729 new
AAA
cases (0.6%). Compared with never smoking, current smoking was associated with 15 times the risk of
AAA
among women (risk ratio 15.0, 95%
CI
13.2–17.0) and 7 times among men (7.3, 6.4–8.2). In women aged <75 years, the risk of
AAA
was nearly 30 times greater in current smokers (26.4, 20.3–34.2). In every age group, the prevalence of
AAA
in female smokers was greater than in male never‐smokers. Positive log‐linear associations with
AAA
for women and men were also observed for usual body mass index, usual systolic blood pressure, height, usual low‐density lipoprotein cholesterol, and usual triglycerides.
Conclusions
Log‐linear increases in the risks of
AAA
with traditional vascular risk factors should be considered when evaluating populations that may be at‐risk for the development of
AAA
, and when considering potential treatments. However, at any given age, female smokers are at higher risk of
AAA
than male never‐smokers, and a policy of screening male never‐smokers but not higher‐risk female smokers is questionable.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Cardiology and Cardiovascular Medicine
Reference31 articles.
1. A Review of Current Reporting of Abdominal Aortic Aneurysm Mortality and Prevalence in the Literature
2. Systematic review and meta-analysis of population-based mortality from ruptured abdominal aortic aneurysm
3. Guirguis‐Blake JM Beil TL Sun X Senger CA Whitlock EP. Primary care screening for abdominal aortic aneurysm: a systematic evidence review for the U.S. Preventive Services Task Force [Internet]. Rockville MD: Agency for Healthcare Research and Quality (US); 2014 Jan. (Evidence Syntheses No. 109.) 4 Discussion. Available from: https://www.ncbi.nlm.nih.gov/books/NBK184795/. Accessed March 4 2019.
4. Screening for abdominal aortic aneurysm;Cosford PA;Cochrane Database Syst Rev,2007
5. Screening for Abdominal Aortic Aneurysm: U.S. Preventive Services Task Force Recommendation Statement
Cited by
21 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献