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Vol 25, No 1 (2019)
Published online: 2019-03-20

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Prevalence and risk factors of abdominal aortic aneurysm among over 65 years old population in Lublin, Poland

Jedrzej Tkaczyk1, Stanisław Przywara2, Michał Terpiłowski1, Klaudia Brożyna1, Marek Iłżecki2, Piotr Terlecki2, Tomasz Zubilewicz2
Acta Angiologica 2019;25(1):1-6.


Introduction: Abdominal aortic aneurysm (AAA) is a disease exceptionally well suited to screening. Ultrasound- based screening meets all criteria for a screening program according to the WHO, and there is a large evidence supporting its usefulness. Risk factors, mentioned in the available literature, associated with aneurysm formation are advanced age, male gender, tobacco smoking, hypertension, atherosclerotic disease and family or personal history of aortic aneurysms. The aim of the study was to evaluate the incidence of abdominal aortic aneurysms in the population of men and women older than 65 years, in Lublin, Poland and to identify the correlation between risk factors and the AAA incidence. Material and methods: A single-center screening study, for men and women older than 65-years was conducted in Lublin, Poland in May 2018. Patients underwent basic screening ultrasound with measurement of the diameter of abdominal aorta and iliac arteries. Each patient completed anonymous questionnaire to investigate risk factors of developing AAA. Results: 1032 patients, aged 65–91 (median age 71.37) were examined. 569 of them were women and 463 men. 27 aortic aneurysms were detected — 7 in a group of women and 20 in a group of men. The total incidence rate of AAA in our study was 2.62%; 1,23% in women and 4,32% in men. Male gender, cigarette smoking, coronary artery disease and a history of myocardial infarction all appeared to be major risk factors of AAA, with relative risk ranging from 2,75 to 4.53. The median diameter of the abdominal aorta was 19.24 mm and varied in groups of patients with different risk factors. Conclusions: The estimated prevalence of AAA in the screened population is within the range of the values reported in previous publications, however, it may confirm a trend of declining prevalence of AAA showed in some recent studies. The presented study confirms the correlation between the AAA and its major risk factors (male sex, smoking cigarettes, coronary artery disease and history of myocardial infarct) as well as a weak association between AAA and hypertension and a negative correlation with diabetes.

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  1. Erbel R, Aboyans V, Boileau C, et al. Authors/Task Force members, ESC Committee for Practice Guidelines. 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). Eur Heart J. 2014; 35(41): 2873–2926.
  2. Jacob AD, Barkley PL, Broadbent KC, et al. Abdominal aortic aneurysm screening. Semin Roentgenol. 2015; 50(2): 118–126.
  3. Guo DC, Papke CL, He R, et al. Pathogenesis of thoracic and abdominal aortic aneurysms. Ann N Y Acad Sci. 2006; 1085: 339–352.
  4. Thompson RW, Liao S, Curci JA. Vascular smooth muscle cell apoptosis in abdominal aortic aneurysms. Coron Artery Dis. 1997; 8(10): 623–631.
  5. Shimizu K, Mitchell RN, Libby P. Inflammation and cellular immune responses in abdominal aortic aneurysms. Arterioscler Thromb Vasc Biol. 2006; 26(5): 987–994.
  6. Lederle FA, Johnson GR, Wilson SE, et al. Prevalence and associations of abdominal aortic aneurysm detected through screening. Aneurysm Detection and Management (ADAM) Veterans Affairs Cooperative Study Group. Ann Intern Med. 1997; 126(6): 441–449.
  7. Cornuz J, Sidoti Pinto C, Tevaearai H, et al. Risk factors for asymptomatic abdominal aortic aneurysm: systematic review and meta-analysis of population-based screening studies. Eur J Public Health. 2004; 14(4): 343–349.
  8. Golledge J, Muller J, Daugherty A, et al. Abdominal aortic aneurysm: pathogenesis and implications for management. Arterioscler Thromb Vasc Biol. 2006; 26(12): 2605–2613.
  9. Svensjö S, Björck M, Gürtelschmid M, et al. Low prevalence of abdominal aortic aneurysm among 65-year-old Swedish men indicates a change in the epidemiology of the disease. Circulation. 2011; 124(10): 1118–1123.
  10. Brady AR, Thompson SG, Fowkes FG, et al. UK Small Aneurysm Trial Participants. Abdominal aortic aneurysm expansion: risk factors and time intervals for surveillance. Circulation. 2004; 110(1): 16–21.
  11. Badger SA, Jones C, McClements J, et al. Surveillance strategies according to the rate of growth of small abdominal aortic aneurysms. Vasc Med. 2011; 16(6): 415–421.
  12. Mureebe L, Egorova N, Giacovelli JK, et al. National trends in the repair of ruptured abdominal aortic aneurysms. J Vasc Surg. 2008; 48(5): 1101–1107.
  13. Bergqvist D, Björck M, Wanhainen A. Abdominal aortic aneurysm and new WHO criteria for screening. Int Angiol. 2013; 32(1): 37–41.
  14. Lindholt JS, Norman P. Screening for abdominal aortic aneurysm reduces overall mortality in men. A meta-analysis of the mid- and long-term effects of screening for abdominal aortic aneurysms. Eur J Vasc Endovasc Surg. 2008; 36(2): 167–171.
  15. Scott R. The Multicentre Aneurysm Screening Study (MASS) into the effect of abdominal aortic aneurysm screening on mortality in men: a randomised controlled trial. The Lancet. 2002; 360(9345): 1531–1539.
  16. Scott R, Wilson NM, Ashton HA, et al. Influence of screening on the incidence of ruptured abdominal aortic aneurysm: 5-year results of a randomized controlled study. British Journal of Surgery. 1995; 82(8): 1066–1070.
  17. Norman P, Jamrozik K, Lawrence-Brown M, et al. Population based randomised controlled trial on impact of screening on mortality from abdominal aortic aneurysm. BMJ. 2004; 329(7477): 1259.
  18. Lindholt JS, Juul S, Fasting H, et al. Hospital costs and benefits of screening for abdominal aortic aneurysms. Results from a randomised population screening trial. Eur J Vasc Endovasc Surg. 2002; 23(1): 55–60.
  19. Cosford PA, Leng GC. Screening for abdominal aortic aneurysm. Cochrane Database Syst Rev. 2007(2): CD002945.
  20. Stather PW, Dattani N, Bown MJ, et al. International variations in AAA screening. Eur J Vasc Endovasc Surg. 2013; 45(3): 231–234.
  21. Hager J, Länne T, Carlsson P, et al. Lower prevalence than expected when screening 70-year-old men for abdominal aortic aneurysm. Eur J Vasc Endovasc Surg. 2013; 46(4): 453–459.
  22. Keisler B, Carter C. Abdominal aortic aneurysm. Am Fam Physician. 2015; 91(8): 538–43.
  23. Jawien A, Formankiewicz B, Derezinski T, et al. Abdominal aortic aneurysm screening program in Poland. Gefasschirurgie. 2014; 19(6): 545–548.
  24. Lederle F. The aneurysm detection and management study screening program. Archives of Internal Medicine. 2000; 160(10): 1425–1430.
  25. Diehm N, Baumgartner I. Determinants of Aneurysmal Aortic Disease. Circulation. 2009; 119(16): 2134–2135.
  26. Weiss JS, Sumpio BE. Review of prevalence and outcome of vascular disease in patients with diabetes mellitus. Eur J Vasc Endovasc Surg. 2006; 31(2): 143–150.
  27. Shantikumar S, Ajjan R, Porter KE, et al. Diabetes and the abdominal aortic aneurysm. European Journal of Vascular and Endovascular Surgery. 2010; 39(2): 200–207.
  28. Pafili K, Gouni-Berthold I, Papanas N, et al. Abdominal aortic aneurysms and diabetes mellitus. J Diabetes Complications. 2015; 29(8): 1330–1336.
  29. Golledge J, Karan M, Moran CS, et al. Reduced expansion rate of abdominal aortic aneurysms in patients with diabetes may be related to aberrant monocyte-matrix interactions. Eur Heart J. 2008; 29(5): 665–672.
  30. Norman PE, Davis TME, Le MT, et al. Matrix biology of abdominal aortic aneurysms in diabetes: mechanisms underlying the negative association. Connect Tissue Res. 2007; 48(3): 125–131.