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Lifetime Risk and Risk Factors for Abdominal Aortic Aneurysm in a 24-Year Prospective Study: The ARIC Study
Weihong Tang1, Lu Yao2, Nicholas S Roetker2
1From the Division of Epidemiology and Community Health (W.T., L.Y., N.S.R., P.L.L., A.R.F.) and Division of Biostatistics (W.G.), School of Public Health, Division of Cardiology (E.M.), Department of Medicine, School of Medicine (F.A.L., D.W.H., E.M.), University of Minnesota, Minneapolis; Department of Imaging (C.C.S.), Minneapolis VA Health Care System (C.C.S., F.A.L.), MN; Health Economics and Outcomes Research, Life Sciences, Optum, Eden Prairie, MN (L.G.S.B.); and Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA (A.A.). tang0097@umn.edu.
Lifetime risk for abdominal aortic aneurysm (AAA) is 5.6% starting at age 45, significantly higher for current smokers. Smoking cessation lowers AAA risk, highlighting its importance in vascular health.
Area of Science:
- Cardiovascular Medicine
- Epidemiology
- Vascular Surgery
Background:
- Abdominal aortic aneurysm (AAA) is a significant vascular disease in older adults.
- Data on the lifetime risk of AAA are limited.
- Understanding midlife risk factors is crucial for AAA prevention.
Purpose of the Study:
- To examine the lifetime risk of AAA in a community-based cohort.
- To assess the association between midlife cardiovascular risk factors and AAA development.
- To evaluate the impact of smoking cessation on AAA lifetime risk.
Main Methods:
- Utilized data from the Atherosclerosis Risk in Communities (ARIC) study (15,792 participants).
- Assessed longitudinal smoking status from 1987-1998.
- Tracked incident clinical AAAs through diagnoses and death certificates until 2011.
- Identified asymptomatic AAAs via ultrasound in 2011-2013.
Main Results:
- At age 45, the estimated lifetime AAA risk was 5.6%, higher in men (8.2%) and current smokers (10.5%).
- At least 1 in 9 middle-aged current smokers developed AAA.
- Smoking cessation between 1987-1998 reduced AAA lifetime risk by 29% compared to continuous smokers.
- Increased risk associated with smoking, white race, male sex, height, LDL, and total cholesterol.
Conclusions:
- Smoking is a major modifiable risk factor for abdominal aortic aneurysm.
- Smoking cessation significantly reduces the lifetime risk of developing AAA.
- Midlife cardiovascular risk factors, including smoking, are associated with both clinical and asymptomatic AAA.
