Partial ileal bypass produces sustained improvement in the blood lipid patterns of patients who have had a myocardial infarction and reduces their subsequent morbidity due to coronary heart disease. The role of this procedure in the management of hypercholesterolemia remains to be determined. These results provide strong evidence supporting the beneficial effects of lipid modification in the reduction of atherosclerosis progression.

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Objective Abdominal aortic aneurysm (AAA) is an important vascular disease in older adults but data on lifetime risk of AAA are sparse. We examined lifetime risk of AAA in a community-based cohort and prospectively assessed the association between mid-life cardiovascular risk factors and AAAs. Approach and Results In ARIC, 15,792 participants were recruited at Visit 1 in 1987–89 and followed-up through 2013. Longitudinal smoking status was defined using smoking behavior ascertained from Visit 1 (1987–89) to Visit 4 (1996–1998). We followed participants for incident, clinical AAAs using hospital discharge diagnoses, Medicare outpatient diagnoses, or death certificates through 2011 and identified 590 incident AAAs. An abdominal ultrasound was conducted in 2011–2013 in 5,911 surviving participants and 75 asymptomatic AAAs were identified. We estimated the lifetime risk of AAA from the index age 45 years through age 85. At age 45, the lifetime risk for AAA was 5.6% (95% confidence interval: 4.8–6.1) and was higher in men (8.2%) and current smokers (10.5%). Smokers who quit smoking between Visit 1 and Visit 4 had a 29% lower AAA lifetime risk compared to continuous smokers but had a higher risk than pre-Visit 1 quitters. The lifetime risk of rupture or medical intervention was 1.6% (95% CI: 1.2, 1.8). Smoking, white race, male gender, and greater height, LDL or total cholesterol were associated with an increased risk of clinical AAA and asymptomatic AAA. Conclusions At least one in 9 middle-aged current smokers developed AAA in their lifetime. Smoking cessation reduced the lifetime risk of AAA.