Prevalence of abdominal aortic aneurysm is still high in certain areas of southern Europe

Abstract

Background: Ultrasound screening of abdominal aortic aneurysm (AAA) has proved to reduce mortality from AAA rupture and has been implemented in several countries. Recent reports show a decreasing prevalence of AAA in Western countries. We report the results from a screening program among 65-year-old men in a defined area in the North of Spain.

Methods: We invited the 1,413 men born in 1943 and registered in the health area under our care to participate in the study. We registered their medical history and cardiovascular risk factors and we performed an abdominal ultrasound scan. We diagnosed an AAA when the infrarenal aortic diameter was ≥3 cm. We performed univariate and multivariate analysis to assess independent factors associated with the development of an AAA, using logistic regression.

Results: The participation rate was 70.8%. The prevalence of active smoking, hypertension, diabetes, and hypercholesterolemia was 19.6%, 52.1%, 25.7%, and 76.9%, respectively. Including 3 previously known and repaired AAAs, the total prevalence of AAA was 4.7% (n=37). The mean diameter of the AAA was 35.7±7.9 mm (range, 30-62 mm). Multivariate analysis confirmed the independent impact of active smoking (Exp[B], 3.47 [95% confidence interval {CI}: 1.67-7.22]), hypertension (Exp[B], 2.43 [95% CI: 1.08-5.45]), and peripheral arterial disease (Exp[B], 3.00 [95% CI: 1.16-7.80]) on the incidence of AAA.

Conclusions: The prevalence of AAA remains high in the studied area in the North of Spain. The potential benefit of lowering smoking rates has not been observed yet. The current international recommendations of screening for 65-year-old men are still applicable in our population.