Exercise in Specific Diseases: Abdominal Aortic Aneurysm

Abstract

An abdominal aortic aneurysm (AAA) is a localized dilation caused by weakening of the vessel wall, most often in the infrarenal area. With the ageing of the population and better detection and screening methods, the prevalence of AAAs has increased markedly in recent years. Today, AAAs account for an increasing burden on health care costs in the Western world. AAA is the 13th leading cause of death in the US and is the third leading cause of sudden death in men >60 years of age, accounting for roughly 4–5% of sudden deaths. AAAs are usually asymptomatic and are often not discovered until they rupture or cause symptoms due to localized pressure on adjacent tissues. Until recently, these patients were generally discouraged from participating in rehabilitation programs because of a lack of data on the impact of exercise on the aneurysm, and whether exercise could be performed safely. However, recent randomized trials have documented that patients with AAA who participate in rehabilitation programs achieve functional benefits that are similar to post-MI patients, and that moderate exercise is not associated with higher safety risks. In fact, given the evolution of cardiac rehabilitation from traditional exercise-based programs to comprehensive secondary prevention and chronic disease management, AAA patients would be ideal candidates for intervention since AAA is a disease strongly associated with cardiometabolic risk. This chapter reviews the available evidence on exercise testing and training in AAA, along with the potential for exercise therapy to reduce AAA risk and limit AAA progression.