To assess the age- and sex-specific prevalence and risk factors for aneurysms of the abdominal aorta, the authors performed a population-based study in 5,419 subjects (42% men, 58% women) aged 55 years and over. The proximal and distal diameter of the abdominal aorta were measured by ultrasound. An aneurysm was defined as a distal aortic diameter of 35 mm or more or a dilatation of the distal part of the the abdominal aorta of 50% or more. The mean distal and proximal aortic diameter increased 0.7 mm and 0.3 mm, respectively, with every 10 years of age. In 2.1% (95% confidence interval (CI) 1.7-2.5) of the study population, an aneurysm was present, or in 4.1% (95% CI 3.2-4.9) of the men and 0.7% (95% CI 0.4-1.0) of the women. Subjects with an abdominal aneurysm were more likely to be smokers and they had higher serum cholesterol levels and higher prevalence of cardiovascular disease compared with subjects without an aneurysm. The authors conclude that the ultrasound diameter of the abdominal aorta clearly increases with age in both men and women and that the prevalence of aneurysms of the abdominal aorta in older adults in relatively high, especially in men.
There was an impressive increase in the hospital based incidence for aneurysms of the abdominal aorta during the past two decades in The Netherlands. An improved detection rate through ultrasound is probably a major contributor to this increase, but gender differences and the rise in the number of ruptured aneurysms suggest that a real increase in incidence may exist, especially in men. Surgical outcome for both ruptured and non-ruptured aneurysms of the abdominal aorta improved.
Effectiveness in screening for abdominal aortic aneurysms can be increased by selecting subjects by means of a short medical questionnaire, filled out by the screening candidates, including questions on medical history.
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