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Screening for abdominal aortic aneurysm: lessons from a population‐based study
Author(s) -
Jamrozik Konrad,
Norman Paul E,
Spencer Carole A,
Parsons Richard W,
Tuohy Raywln,
MLawrenceBrown Mlcheel,
Dickinson James A
Publication year - 2000
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2000.tb125684.x
Subject(s) - medicine , abdominal aortic aneurysm , odds ratio , population , waist , abdominal obesity , cross sectional study , abdominal aorta , logistic regression , diabetes mellitus , aneurysm , physical therapy , demography , aorta , surgery , obesity , environmental health , pathology , sociology , endocrinology
Objectives To test the acceptability of screening and to identify modifiable risk factors for abdominal aortic aneurysm (AAA) in men. Design A trial of ultrasound screening for AAA in a population‐based random sample of men aged 65‐83 years, and a cross‐sectional case‐control comparison of men in the same sample. Participants 12 203 men who had an ultrasound examination of their abdominal aorta, and completed a questionnaire covering demographic, behavioural and medical factors. Main outcome measures Prevalence of AAA, and independent associations of AAA with demographic, medical and lifestyle factors. Results Invitations to screening produced a corrected response of 70.5%. The prevalence of AAAs (> 30 mm) rose from 4.8% in men aged 65‐69 years to 10.8% in those aged 80‐83 years. The overall prevalence of large (> 50 mm) aneurysms was 0.69%. In a multivariate logistic model Mediterranean‐born men had a 40% lower risk of AAA (> 30 mm) compared with men born in Australia (odds ratio [OR], 0.6; 95% Cl, 0.4‐0.8), while ex‐smokers had a significantly increased risk of AAA (OR, 2.3; 95% Cl, 1.9‐2.8), and current smokers had even higher risks. AAA was significantly associated with established coronary and peripheral arterial disease and a waist: hip ratio greater than 0.9; men who regularly undertook vigorous exercise had a lower risk (OR, 0.8; 95% Cl, 0.7‐1.0). Conclusion Ultrasound screening for AAA is acceptable to men in the likely target population. AAA shares some but not all of the risk factors for occlusive vascular disease, but the scope for primary prevention of AAA in later life is limited.