Abstract 13687: The Association of Trends in Classic Cardiovascular Risk Factors With Global Trends in Abdominal Aortic Aneurysm Mortality
Introduction: Contemporary data from western populations have reported steep declines in abdominal aortic aneurysm (AAA) incidence and mortality during the 21st century. This study aims to establish current global trends in AAA mortality and the association of common cardiovascular risk factors with these trends.
Methods: Mortality data was extracted from the World Health Organisation (WHO) mortality database by use of all ICD codes relating to AAA, and age standardised to allow comparison between countries. Risk factor data was extracted from the WHO InfoBase and smoking data was extracted from the international mortality and smoking statistics database. After exclusion of countries based on completeness of statistics and availability of risk factor data, the following 19 countries were included into this study: Australia, Austria, Canada, Denmark, Finland, France, Germany, Hungary, Iceland, Israel, Japan, Netherlands, New Zealand, Norway, Romania, Spain, Sweden, UK and USA. Regression analysis of temporal trends in all risk factors (1980-2010) was performed, and compared to trends in AAA mortality for each country.
Results: AAA mortality appears to be declining globally however, the USA and UK have the fastest declining AAA mortality in both genders with the observed decline greatest in males and the under 75 age group. A positive linear relationship exists between global trends in systolic blood pressure (P=0.028, P=0.024), cholesterol (P=0.0082, P=0.024), smoking prevalence (P=0.017, P=0.00021) and AAA mortality whilst BMI (P=0.0072, P=0.0039) appears to have a negative linear association with AAA mortality in males and females respectively. AAA mortality was not significantly associated with population trends in mean fasting blood glucose.
Conclusion: This study provides evidence that AAA mortality is declining globally however, that this decline is not equal between countries, gender or age. Public health measures could further reduce AAA mortality however, the finding that the observed decline in mortality is greatest in the under 75 age group suggests that risk factor modification may delay the presentation of clinically relevant AAA rather than reducing risk altogether.
- © 2013 by American Heart Association, Inc.