CHICAGO (October 01, 2007) — abdominal aortic aneurysms (AAAs) are formed when a weak area of the aorta expands or bulges; sometimes they contain clots which can travel throughout the body and block other blood vessels. Also, AAAs can rupture and require surgical repair.
Most studies assessing the prevalence and associated risk factors for AAA have focused on men. However a new study in the October 2007 issue of the Journal of Vascular Surgery presents the largest screening study ever done on women with this disease.
We found AAAs were more likely to be found in women 65 years and older with a history of heart disease or tobacco use, said senior author K. Craig Kent, MD, chief of vascular surgery at New York Presbyterian Hospital in New York City. Our results showed that females who are current or former smokers are four times more likely than non-smokers to have aneurysmal disease; also, women with a prior heart attack, heart bypass surgery or coronary angioplasty are 3.6 times more likely to have an aneurysm.
A total of 10,012 women and 7,528 men were screened for AAA in the study. While the overall prevalence of AAA was only 0.7 percent in women (74 patients) compared to 3.9 percent (291 patients) in men, females with multiple risk factors were more likely to have an aneurysm, added Dr. Kent. In our study females over 65 years of age with three other risk factors were found to have a prevalence rate as high as 6.4 percent.
Dr. Kent noted that in the past most data has been accumulated to support the screening of all men between the ages of 65 to 75 years who have ever smoked. He added that it has not been well established whether the same factors that increase the likelihood of AAA in men have the same effect in women, and whether there are subgroups of women at sufficiently high risk of AAA to undergo screening. Although women are generally believed to have a lower prevalence rate of AAA than men, prior studies have demonstrated that women are at increased risk of death following rupture and are at increased risk of rupturing aneurysms of smaller sizes, added Dr. Kent. Identifying subgroups of women who have a heightened risk of AAA is extremely important, as they may be as likely to benefit from screening programs as men with similar risk factors.
Abdominal aortic aneurysms lead to as many as 30,000 deaths annually in the United States alone, according to the researchers. Approximately half of all patients who present to an emergency room with a ruptured AAA do not survive.
The greatest potential for improving the mortality rate associated with AAA depends on early detection and elective repair of AAA before rupture, said Dr. Kent. Recently, reductions in the death rate from AAA have been demonstrated following the screening of specific patient groups with a brief non-invasive ultrasound examination. For screening to be clinically feasible or cost-effective, it should be directed at both male and female patients who have an increased likelihood of harboring the disease being sought.