The Aneurysm Detection and Management Study Screening Program

Abstract

Background: We previously reported the prevalence and associations of abdominal aortic aneurysm (AAA) in 73451 veterans aged 50 to 79 years who underwent ul- trasound screening. Objective: To understand the prevalence of and prin- cipal positive and negative risk factors for AAA, and to assess reproducibility of our previous findings. Methods: In the new cohort of veterans undergoing screening, 52745 subjects aged 50 to 79 without history of AAA underwent successful ultrasound screening for AAA, after completing a questionnaire on demograph- ics and potential risk factors. Results: We detected AAA of 4.0 cm or larger in 613 participants (1.2%; compared with 1.4% in the earlier cohort). The direction and magnitude of the important associations reported in the first cohort were con- firmed. Respective odds ratios for the major associa- tions with AAA for the second and for the combined co- horts were as follows: 1.81 and 1.71 for age (per 7 years), 0.12 and 0.18 for female sex, 0.59 and 0.53 for black race, 1.94 and 1.94 for family history of AAA, 4.45 and 5.07 for smoking, 0.50 and 0.52 for diabetes, and 1.60 and 1.66 for atherosclerotic diseases. The excess prevalence asso- ciated with smoking accounted for 75% of all AAAs of 4.0 cm or larger in the total population of 126196. As- sociations forAAAof 3.0 to 3.9cmwere similar but tended to be somewhat weaker. Conclusions: Our findings confirm our previous cohort findings. Age, smoking, family history of AAA, and atherosclerotic diseases remained the principal positive associations with AAA, and female sex, diabe- tes, and black race remained the principal negative associations.