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(Circulation. 2009;119:2134-2135.)
© 2009 American Heart Association, Inc.

Editorial

Determinants of Aneurysmal Aortic Disease

Nicolas Diehm, MD; Iris Baumgartner, MD

From the Swiss Cardiovascular Center, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.

Correspondence to Iris Baumgartner, MD, Head of Clinical and Interventional Angiology, Swiss Cardiovascular Center, Inselspital, Bern University Hospital and University of Bern, 3010 Bern, Switzerland. E-mail Iris.baumgartner@insel.ch

Key Words: Editorials • aneurysm • aorta

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Abdominal aortic aneurysm (AAA) imposes a burden of epidemic proportions. Screening programs in the United States and in Europe have shown that 5% of men >65 years of age have an occult AAA,¹ and therefore, an understanding of the determinants of AAA is essential to the design of effective interventions. The article by Forsdahl and colleagues² in this issue of Circulation specifically addresses this important issue in a cohort of 4345 men and women in Tromsø, Norway. The authors report that male sex, increasing age, and smoking are prominent risk factors for incident AAA in the next 7 years. This is consistent with previously reported studies, which provides reassurance regarding the robustness of the data.^3–7 Epidemiological screening studies also suggest a strong association of AAA with atherosclerosis, coronary artery disease, and peripheral arterial disease. The aortic diameter in individuals with AAA detected by screening is rarely of a size associated with a short-term risk for aneurysm-related death (ie, rupture) but rather with a 1.5- to 3-fold increase in cardiovascular morbidity and mortality due to arterial occlusive disease.^8,9

Article p 2202

An association between aneurysmal and atherosclerotic occlusive disease, both of which are characterized by a chronic inflammatory reaction, matrix degeneration, and vascular tissue remodeling, appears to be obvious, with common risk factors linking them. On closer examination, however, this does not apply to all of them; there are even undeniable exceptions. Smoking is associated with AAA in men 2.5 times more frequently than it is associated with coronary artery disease.¹⁰ . . . [Full Text of this Article]