Related Experiment Videos
Middle age cardiovascular risk factors and abdominal aortic aneurysm in older age
Miriam B Rodin1, Martha L Daviglus, Gordon C Wong
1Division of Geriatrics, Department of Medicine, University of Chicago Pritzker School of Medicine, Chicago, USA.
Insights
Major cardiovascular risk factors like high cholesterol, smoking, and blood pressure in middle age significantly increase the risk of developing abdominal aortic aneurysms later in life.
Area of Science:
- Cardiovascular epidemiology
- Vascular surgery
- Public health
Background:
- Limited prospective research exists on cardiovascular risk factors and abdominal aortic aneurysm (AAA) incidence.
- Previous cross-sectional study findings on this association are inconsistent.
Purpose of the Study:
- To investigate the long-term relationship between major cardiovascular risk factors in middle age and the occurrence of abdominal aortic aneurysm (AAA) in older age.
- To analyze these associations within the Chicago Heart Association Detection Project in Industry cohort.
Main Methods:
- A long-term, population-based study involving 10,574 men and 8,700 women screened for risk factors between 1967-1973.
- Average follow-up of 30 years, with AAA cases identified through Medicare records and death certificates.
- Cox regression analysis was used to assess risk factor relationships with AAA occurrence.
Main Results:
- Significant associations were found between middle-age cardiovascular risk factors and later-life AAA occurrence in both men and women.
- Increased hazard ratios for AAA were observed with older age, higher serum cholesterol, smoking (current and past), and adverse blood pressure indicators, including treated hypertension.
- Men generally showed higher hazard ratios compared to women for most risk factors.
Conclusions:
- Major cardiovascular risk factors, including serum cholesterol, smoking, and blood pressure, identified in middle age are significantly associated with the risk of developing abdominal aortic aneurysm (AAA) in older age.
- These findings underscore the importance of managing cardiovascular health in midlife to mitigate future AAA risk.
Abstract:
Few prospective studies have examined associations between major cardiovascular risk factors and occurrence of abdominal aortic aneurysm; findings from cross-sectional studies are inconsistent. This long-term population-based study assessed relationships of major risk factors in middle-age to clinical nonfatal plus fatal abdominal aortic aneurysm in older-age in the Chicago Heart Association Detection Project in Industry cohort--10 574 men and 8700 women baseline ages 40 to 64 years screened for risk factors in 1967-1973 at workplaces. With average follow-up of 30 years and clinical cases identified from Medicare records and death certificates, risk factor relationships to abdominal aortic aneurysm occurrence were assessed by Cox regression. There were among men 309 cases and among women, 109--most from Medicare records. Most findings were qualitatively similar for men and women. In multivariate analyses (5 models), hazard ratios for abdominal aortic aneurysm were significantly greater for men than women (> or =1.97), with older age (> or =1.63/5 years), higher serum cholesterol (> or =1.30/40.0 mg/dL), cigarettes/d (> or =2.43/20 cigarettes), past smoking (> or =1.41), height (> or =1.17/7 cm), evidence of adverse blood pressure (hazard ratio 1.10/20 mm Hg higher systolic pressure, 1.12 to 1.14/12 mm Hg higher diastolic pressure, 1.87 with history of treated hypertension). It is concluded that major cardiovascular risk factors--serum cholesterol, smoking, and blood pressure--in middle age relate significantly to risk of abdominal aortic aneurysm in persons surviving into older age.