Prevalence and natural history of and risk factors for subaneurysmal aorta among 65-year-old men

  • Knut Thorbjørnsen Department of Surgical Sciences, Section of Vascular Surgery, Uppsala University, Uppsala, Sweden; Centre for Research and Development, Uppsala University/County Council of Gävleborg, Gävle, Sweden;
  • Sverker Svensjö Department of Surgical Sciences, Section of Vascular Surgery, Uppsala University, Uppsala, Sweden; Centre for Research and Development, Uppsala University/County Council of Gävleborg, Gävle, Sweden;
  • Khatereh Djavani Gidlund Department of Surgical Sciences, Section of Vascular Surgery, Uppsala University, Uppsala, Sweden; Centre for Research and Development, Uppsala University/County Council of Gävleborg, Gävle, Sweden;
  • Nils-Peter Gilgen Department of Surgery, Eskilstuna County Hospital, Eskilstuna, Sweden
  • Anders Wanhainen Department of Surgical Sciences, Section of Vascular Surgery, Uppsala University, Uppsala, Sweden
Keywords: Abdominal aortic aneurysm, prevention and control, screening, smoking, subaneurysmal aorta, ultrasonography

Abstract

Background: The aims of this study were to determine the prevalence of screening-detected subaneurysmal aorta (SAA), i.e. an aortic diameter of 2.5–2.9 cm, its associated risk factors, and natural history among 65-year-old men.

Methods: A total of 14,620 men had their abdominal aortas screened with ultrasound and completed a health questionnaire containing information on smoking habits and medical history. They were categorized based on the aortic diameter: normal aorta (<2.5 cm; n = 14,129), SAA (2.5–2.9 cm; n = 258), and abdominal aortic aneurysm (AAA) (≥3.0 cm; n = 233). The SAA-group was rescanned after 5 years. Associated risk factors were analyzed.

Results: The SAA-prevalence was 1.9% (95% confidence interval 1.7%–2.1%), with 57.0% (50.7%–63.3%) expanding to ≥3.0 cm within 5 years. Frequency of smoking, coronary artery disease, hypertension, hyperlipidemia, and claudication were significantly higher in those with SAA and AAA compared to those with normal aortic diameter. Current smoking was the strongest risk factor for SAA (odds ratio [OR] 2.8; P < 0.001) and even stronger for AAA (OR 3.6; P < 0.001). Men with SAA expanding to AAA within 5 years presented pronounced similarities to AAA at baseline.

Conclusions: Men with SAA and AAA presented marked similarities in the risk factor profile. Smoking was the strongest risk factor with an incremental association with disease severity, and disease progression. This indicates that SAA and AAA may have the same pathophysiological origin and that SAA should be considered as an early stage of aneurysm formation. Further research on the cost-effectiveness and potential benefits of surveillance as well as smoking cessation and secondary cardiovascular prevention in this subgroup is warranted.

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Published
2019-08-28
How to Cite
Thorbjørnsen K., Svensjö S., Gidlund K. D., Gilgen N.-P., & Wanhainen A. (2019). Prevalence and natural history of and risk factors for subaneurysmal aorta among 65-year-old men. Upsala Journal of Medical Sciences, 124(3), 180-186. https://doi.org/10.1080/03009734.2019.1648611
Section
Original Articles

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