New Scoring System Finds More People at Risk for Abdominal Aortic Aneurysm

Madison, Wisconsin - Current guidelines for screening people at risk for abdominal aortic aneurysm (AAA) miss almost half those at risk for a fatal rupture, including all the women, says the lead author of a large study on condition.

"(AAA) is less common in women, but it is still very, very fatal," says Dr. K. Craig Kent, chair of surgery at the University of Wisconsin School of Medicine and Public Health.

When an aneurysm in the body's largest artery bursts, it is fatal about 85 percent of the time. But if aneurysms are detected by ultrasound and repaired surgically before they burst, the condition is quite treatable.

The question is: Who should get the screening ultrasounds?

Kent, along with colleagues from the Mount Sinai School of Medicine Department of Health Evidence and Policy in New York City, evaluated the data of 3.1 million patients who were at risk for an abdominal aortic aneurysm.

Their research showed that about half the patients having abdominal aortic aneurysm disease are not eligible for screening under current Medicare guidelines, which currently limit ultrasounds to men who are over the age of 65 and who have smoked cigarettes.

But the researchers estimated that there are 1.1 million abdominal aortic aneurysms in the United States, of which 569,000 are among women, patients who never smoked or were age 65 or younger.

"We created a new scoring system that allows us to find many, many more aneurysms in a much larger population, with fewer ultrasounds," Kent says.

The data came from more than 20,000 Life Line Screening sites across the nation. Patients completed a medical and lifestyle survey and were evaluated by ultrasound for abdominal aortic aneurysm.

The study also showed that smoking cessation and a healthy lifestyle are associated with lower risk of abdominal aortic aneurysm. Researchers observed a positive association for abdominal aortic aneurysm with increasing years of smoking, the number of cigarettes smoked and a negative association with smoking cessation.

Excess weight was associated with increased risk, whereas exercise and consumption of nuts, vegetables, and fruits were associated with reduced risk. Blacks, Hispanics, and Asians had lower risk of having abdominal aortic aneurysm than whites and Native Americans.

The study was published in the September issue of the Journal of Vascular Surgery.