Article Text

PDF
Smoking, sex, risk factors and abdominal aortic aneurysms: a prospective study of 18 782 persons aged above 65 years in the Southern Community Cohort Study
  1. Eiman Jahangir1,2,
  2. Loren Lipworth1,
  3. Todd L Edwards1,
  4. Edmond K Kabagambe1,
  5. Michael T Mumma3,
  6. George A Mensah4,
  7. Sergio Fazio5,
  8. William J Blot1,3,
  9. Uchechukwu K A Sampson1,6,7
  1. 1Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
  2. 2John Ochsner Heart and Vascular Institute, Ochsner Clinical School- The University of Queensland School of Medicine, New Orleans, Louisiana, USA
  3. 3International Epidemiology Institute, Rockville, Maryland, USA
  4. 4National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
  5. 5Center of Preventive Cardiology, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
  6. 6Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
  7. 7Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
  1. Correspondence to Dr Eiman Jahangir, John Ochsner Heart and Vascular Institute, Ochsner Clinical School—The University of Queensland School of Medicine, 1514 Jefferson Highway, New Orleans, LA 70121-2483 USA; ejahangir{at}ochsner.org

Abstract

Background Abdominal aortic aneurysm (AAA) is a leading cause of death in the USA. We evaluated the incidence and predictors of AAA in a prospectively followed cohort.

Methods We calculated age-adjusted AAA incidence rates (IR) among 18 782 participants aged ≥65 years in the Southern Community Cohort Study who received Medicare coverage from 1999–2012, and assessed predictors of AAA using multivariable Cox proportional hazards models, overall and stratified by sex, adjusting for demographic, lifestyle, socioeconomic, medical and other factors. HRs and 95% CIs were calculated for AAA in relation to factors ascertained at enrolment.

Results Over a median follow-up of 4.94 years, 281 cases were identified. Annual IR was 153/100 000, 401, 354 and 174 among blacks, whites, men and women, respectively. AAA risk was lower among women (HR 0.48, 95% CI 0.36 to 0.65) and blacks (HR 0.51, 95% CI 0.37 to 0.69). Smoking was the strongest risk factor (former: HR 1.91, 95% CI 1.27 to 2.87; current: HR 5.55, 95% CI 3.67 to 8.40), and pronounced in women (former: HR 3.4, 95% CI 1.83 to 6.31; current: HR 9.17, 95% CI 4.95 to 17). A history of hypertension (HR 1.44, 95% CI 1.04 to 2.01) and myocardial infarction or coronary artery bypass surgery (HR 1.9, 95% CI 1.37 to 2.63) was negatively associated, whereas a body mass index ≥25 kg/m2 (HR 0.72; 95% CI 0.53 to 0.98) was protective. College education (HR 0.6, 95% CI 0.37 to 0.97) and black race (HR 0.44, 95% CI 0.28 to 0.67) were protective among men.

Conclusions Smoking is a major risk factor for incident AAA, with a strong and similar association between men and women. Further studies are needed to evaluate benefits of ultrasound screening for AAA among women smokers.

  • VASCULAR DISEASE
  • Epidemiology of cardiovascular disease
  • EPIDEMIOLOGY
  • SMOKING

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles