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(Circulation. 2009;119:2202-2208.)
© 2009 American Heart Association, Inc.

Vascular Medicine

Risk Factors for Abdominal Aortic Aneurysms

A 7-Year Prospective Study: The Tromsø Study, 1994–2001

Signe Helene Forsdahl, MD; Kulbir Singh, MD, PhD; Steinar Solberg, MD, PhD; Bjarne K. Jacobsen, PhD

From the Institute of Community Medicine (S.H.F., B.K.J.), University of Tromsø, Tromsø, Norway; Department of Radiology (K.S.), University Hospital of North Norway, Tromsø, Norway; and Department of Thoracic Surgery (S.S.), Rikshospitalet, Oslo, Norway.

Correspondence to Dr Signe Helene Forsdahl, MD, Institute of Community Medicine, University of Tromsø, 9037 Tromsø, Norway. E-mail signe.helene.forsdahl{at}ism.uit.no

Received September 1, 2008; accepted January 12, 2009.

Background— Abdominal aortic aneurysm is an asymptomatic condition with a high mortality rate related to rupture.

Methods and Results— In a cohort of 2035 men and 2310 women in Tromsø, Norway, who were 25 to 82 years old in 1994, the authors identified risk factors for incident abdominal aortic aneurysm over the next 7 years. The impact of smoking was studied in particular. Ultrasound examination was performed initially in 1994/1995 and repeated in 2001. There were 119 incident cases of abdominal aortic aneurysms (an incidence of 0.4% per year). Male sex and increasing age were strong risk factors. In addition, the following variables were significantly associated with increased abdominal aortic aneurysm incidence: Smoking (OR=13.72, 95% CI 6.12 to 30.78, comparing current smokers of 20 cigarettes/d with never-smokers), hypertension (OR=1.54, 95% CI 1.03 to 2.30), hypercholesterolemia (OR=2.11, 95% CI 1.23 to 3.64, comparing subjects with serum total cholesterol 7.55 mmol/L with those with total cholesterol <5.85 mmol/L), and low high-density lipoprotein cholesterol (OR=3.25, 95% CI 1.68 to 6.27, comparing subjects with high-density lipoprotein cholesterol <1.25 mmol/L with those with high-density lipoprotein 1.83 mmol/L). In addition, use of statins was associated with increased risk of abdominal aortic aneurysm (OR=3.77, 95% CI 1.45 to 9.81), but this was probably a marker of high risk of cardiovascular diseases.

Conclusions— The results demonstrate strong associations between traditional atherosclerosis risk factors and the risk of incident abdominal aortic aneurysms.

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