Cardiovascular Disease and Mortality in Older Adults with Small Abdominal Aortic Aneurysms Detected by Ultrasonography: The Cardiovascular Health Study
- 6 February 2001
- journal article
- Published by American College of Physicians in Annals of Internal Medicine
- Vol. 134 (3), 182-190
- https://doi.org/10.7326/0003-4819-134-3-200102060-00008
Abstract
Persons with abdominal aortic aneurysm are more likely to have a higher prevalence of risk factors for and clinical manifestations of cardiovascular disease. It is unknown whether these factors explain the high mortality rate associated with abdominal aortic aneurysm. To describe the risk for mortality, cardiovascular mortality, and cardiovascular morbidity in persons screened for abdominal aortic aneurysm. Longitudinal cohort study. Four communities in the United States. 4734 men and women older than 65 years of age recruited from Medicare eligibility lists. Abdominal ultrasonography was used to measure the aortic diameter and the ratio of infrarenal to suprarenal measurement of aortic diameter in 1992–1993. Abdominal aortic aneurysm was defined as aortic diameter of 3 cm or greater or infrarenal-to-suprarenal ratio of 1.2 or greater. Mortality, cardiovascular disease mortality, incident cardiovascular disease, and repair or rupture were assessed after 4.5 years. The prevalence of aneurysm was 8.8%, and 87.7% of aneurysms were 3.5 cm or less in diameter. Rates of total mortality (65.1 vs. 32.8 per 1000 person-years), cardiovascular mortality (34.3 vs. 13.8 per 1000 person-years), and incident cardiovascular disease (47.3 vs. 31.0 per 1000 person-years) were higher in participants with aneurysm than in those without aneurysm; after adjustment for age, risk factors, and presence of other cardiovascular disease, the respective relative risks were 1.32, 1.36, and 1.57. Rates of repair and rupture were low. Rates of total mortality, cardiovascular disease mortality, and incident cardiovascular disease were higher in participants with abdominal aortic aneurysm than in those without aneurysm, independent of age, sex, other clinical cardiovascular disease, and extent of atherosclerosis detected by noninvasive testing. Persons with smaller aneurysms detected by ultrasonography should be advised to modify risk factors for cardiovascular disease while under surveillance for increase in the size of the aneurysm.Keywords
This publication has 8 references indexed in Scilit:
- Risk Factors for Abdominal Aortic Aneurysm: Results of a Case-Control StudyAmerican Journal of Epidemiology, 2000
- Prevalence and risk factors for abdominal aortic aneurysms in older adults with and without isolated systolic hypertensionThe American Journal of Cardiology, 1999
- Growth rates and risk of rupture of abdominal aortic aneurysmsBritish Journal of Surgery, 1998
- The fate of patients undergoing surveillance of small abdominal aortic aneurysmsEuropean Journal of Vascular and Endovascular Surgery, 1998
- Risk Factors for Abdominal Aortic Aneurysms in Older Adults Enrolled in the Cardiovascular Health StudyArteriosclerosis, Thrombosis, and Vascular Biology, 1996
- Recruitment of adults 65 years and older as participants in the cardiovascular health studyAnnals of Epidemiology, 1993
- The cardiovascular health study: Design and rationaleAnnals of Epidemiology, 1991
- Clinical Fate of the Patient With Asymptomatic Abdominal Aortic Aneurysm and Unfit for Surgical TreatmentArchives of Surgery, 1972