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. 2017 May 10;6(5):e004725.
doi: 10.1161/JAHA.116.004725.

Lifestyle and Risk of Screening-Detected Abdominal Aortic Aneurysm in Men

Otto Stackelberg  1   2   3 , Alicja Wolk  4 , Ken Eliasson  5 , Anders Hellberg  3   6 , Adam Bersztel  3   6 , Susanna C Larsson  4 , Nicola Orsini  4 , Anders Wanhainen  3 , Martin Björck  3
Affiliations

Lifestyle and Risk of Screening-Detected Abdominal Aortic Aneurysm in Men

Otto Stackelberg et al. J Am Heart Assoc. .

Abstract

Background: Modifiable lifestyle-related factors associated with risk of abdominal aortic aneurysm (AAA) are rarely investigated with a prospective design. We aimed to study possible associations among such factors and comorbidities with mean abdominal aortic diameter (AAD) and with risk of AAA among men screened for the disease.

Methods and results: Self-reported lifestyle-related exposures were assessed at baseline (January 1, 1998) among 14 249 men from the population-based Cohort of Swedish Men, screened for AAA between 65 and 75 years of age (mean 13 years after baseline). Multivariable prediction of mean AAD was estimated with linear regression, and hazard ratios (HRs) of AAA (AAD ≥30 mm) with Cox proportional hazard regression. The AAA prevalence was 1.2% (n=168). Smoking, body mass index, and cardiovascular disease were associated with a larger mean AAD, whereas consumption of alcohol and diabetes mellitus were associated with a smaller mean AAD. The HR of AAA was increased among participants who were current smokers with ≥25 pack-years smoked compared with never smokers (HR 15.59, 95% CI 8.96-27.15), those with a body mass index ≥25 versus <25 (HR 1.89, 95% CI, 1.22-2.93), and those with cardiovascular disease (HR 1.77, 95% CI, 1.13-2.77), and hypercholesterolemia (HR 1.59, 95% CI 1.08-2.34). Walking or bicycling for >40 minutes/day (versus almost never) was associated with lower AAA hazard (HR 0.59, 95% CI 0.36-0.97) compared with almost never walking or bicycling.

Conclusions: This prospective study confirms that modifiable lifestyle-related factors are associated with AAD and with AAA disease.

Keywords: abdominal aortic aneurysm; cohort study; epidemiology; lifestyle; risk factor.

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Figures

Figure 1
Figure 1
Predicted mean difference in abdominal aortic diameter by (A) pack‐years smoked and (B) body mass index. Fitted with restricted cubic splines with 3 knots of the exposure distribution and modeled with multivariable linear regression according to Table 2. Dashed lines represent 95% confidence limits. Tick marks represent distribution of cases, and histograms represent distribution of exposure.
Figure 2
Figure 2
Hazard ratios of abdominal aortic aneurysm (AAA) by (A) pack‐years smoked and (B) body mass index. Fitted with restricted cubic splines with 3 knots of the exposure distribution and modeled with multivariable Cox proportional hazards regression according to Table 3. Dashed lines represent 95% confidence limits. Tick marks represent distribution of cases, and histograms represent distribution of exposure.
See this image and copyright information in PMC

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