Factors associated with development of large abdominal aortic aneurysm in middle-aged men

Objectives. To investigate whether any variables in a health-screened population study were associated with later developnent of large abdominal aortic aneurysms (AAA). Setting. Malmo, Southern Sweden. Material and methods. Within the Malmo Preventive Study 22,444 men and 10,982 women were investigated between 1974 and 1991. The mean age at the health screening was 43.7 years. Results. After a median follow-up of 21 years, 126 men and six women (p < 0.001) had large AAA that were symptomatic or evaluated for operation (5 cm diameter or more) or had autopsy-verified ruptured AAA. The male group (mean age 47 years) was, because of difference in age (p < 0.001) also compared with an age-matched control group. The male patients with AAA showed increased diastolic blood pressure (p < 0.007) tit the health screening, Smoking predicted the development of AAA (p < 0.0001). No difference in forced vital capacity or BMI was seen. Those who were inactive (e.g. not walking or cycling to work) had an increased risk of developing AAA (p < 0.001). Among the laboralortl markers measured, the erythrocyte sedimentation rate did not differ (7.1 +/- 5.9 vs. 6.4 +/- 5.7), but cholesterol (6.3 +/- 1.12 vs. 5.8 +/- 1.0) (p < 0.0001) and triglycerides (1.9 +/- 0.12 vs. 1.5 +/- 0.07) (p < 0.001) were significantly elevated in these individuals who subsequently developing AAA. The inflammatory proteins alfa-1-antitrypsin, ceruloplasmin, orosmucoid, fibrinogen, and haptoglobulin were increased (p < 0.001). Conclusion. Male gender, sinoking, physical inactivity and cholesterol are significant factors associated with the of AAA.