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Factors associated with small abdominal aortic aneurysm expansion rate
Rachel H Bhak1, Michael Wininger2, Gary R Johnson1
1Department of Veterans Affairs Cooperative Studies Program Coordinating Center, West Haven, Connecticut 2Yale School of Public Health, Yale University, West Haven, Connecticut.
JAMA Surgery
|November 13, 2014
Summary
Smoking cessation and controlling diastolic blood pressure can slow abdominal aortic aneurysm (AAA) expansion. These factors are key to managing AAA growth and reducing rupture risk.
Area of Science:
- Vascular Surgery
- Cardiovascular Medicine
- Medical Diagnostics
Background:
- Abdominal aortic aneurysms (AAAs) pose a high mortality risk upon rupture.
- Surveillance is crucial for detecting AAA expansion, but risk factor effects are unclear.
- Understanding AAA expansion patterns is vital for effective patient management.
Purpose of the Study:
- To identify clinical risk factors influencing AAA expansion rates.
- To differentiate factors associated with constant versus accelerated AAA expansion.
- To inform strategies for mitigating AAA growth.
Main Methods:
- A multivariate mixed-effects model analyzed AAA expansion rates.
- Shape factor analysis distinguished steady from accelerated expansion.
- Data from 567 patients in the ADAM study (1992-2000) were utilized.
Main Results:
- The average linear AAA expansion rate was 0.26 cm/year.
- Current smoking and higher diastolic blood pressure increased expansion rates.
- Diabetes mellitus was associated with a decreased expansion rate.
Conclusions:
- Smoking cessation and diastolic blood pressure control are recommended to slow AAA expansion.
- Diabetes mellitus showed a protective association with AAA expansion.
- Distinct AAA expansion trajectories were observed, warranting further research.
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