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Difference in risk factor profile for abdominal aortic aneurysm and thoracic aortic aneurysm
Umeå universitet, Medicinska fakulteten, Institutionen för diagnostik och intervention.
Umeå universitet, Medicinska fakulteten, Institutionen för diagnostik och intervention.
Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Umeå universitet, Medicinska fakulteten, Institutionen för diagnostik och intervention. Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.ORCID-id: 0000-0002-3273-8726
2025 (Engelska)Ingår i: Journal of Vascular Surgery, ISSN 0741-5214, E-ISSN 1097-6809, Vol. 81, nr 2, s. 335-341.e6Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objective: Previous studies suggest partly different risk factor profiles of thoracic aortic aneurysms (TAAs) and abdominal aortic aneurysms (AAAs), but prospective data are scarce. The purpose of this prospective population-based case-control study was to investigate differences in risk factor profile between TAAs and AAAs.

Methods: Participants in two prospective population-based studies, the Västerbotten Intervention Project (VIP) and the Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) study, between 1986 and 2010, underwent cardiovascular risk assessments, including blood samples, oral glucose tolerance test, blood pressure readings, and a self-reported health questionnaire. All individuals who were later diagnosed with TAAs or AAAs were identified. Age, sex, and time-matched controls were selected from the same cohorts, aiming at four controls/case. Adjusted odds ratios (aORs) for potential risk factors for later diagnosis of TAAs and AAAs, respectively, were estimated by multivariate conditional logistic regression analyses.

Results: From a total of 96,196 individuals with prospectively collected data in the VIP/MONICA cohort, a total of 236 individuals with AAAs (181 men and 55 women) and 935 matched controls, and 168 individuals with TAAs (115 men and 53 women) and 662 controls were included. The average age at baseline examination was 57.0 ± 5.7 years for AAA cases and controls, and 52.1 ± 8.8 years for TAA cases and controls. Mean time between baseline examination and diagnosis of AAAs/TAAs was 12.1 and 11.7 years, respectively. There was a clear difference in risk factor profile between AAAs and TAAs. Smoking, hypertension, and coronary artery disease were significantly associated with later diagnosis of AAAs, with highest aORs for a history of smoking (aOR, 10.3; 95% confidence interval [CI], 6.3-16.8). For TAAs, hypertension was the only positive risk factor (aOR, 1.7; 95% CI, 1.1-2.7), whereas smoking was not associated. Diabetes was not associated with either AAAs or TAAs; neither was self-reported physical activity.

Conclusions: In this prospective, population-based, case-control study, risk factor profile differed between AAAs and TAAs. This suggests a partially different etiology for TAAs and AAAs.

Ort, förlag, år, upplaga, sidor
Elsevier, 2025. Vol. 81, nr 2, s. 335-341.e6
Nyckelord [en]
Abdominal aortic aneurysm, Risk factor, Thoracic aortic aneurysm
Nationell ämneskategori
Kirurgi Kardiologi och kardiovaskulära sjukdomar
Identifikatorer
URN: urn:nbn:se:umu:diva-232505DOI: 10.1016/j.jvs.2024.10.012ISI: 001401498600001PubMedID: 39423933Scopus ID: 2-s2.0-85210038814OAI: oai:DiVA.org:umu-232505DiVA, id: diva2:1917623
Forskningsfinansiär
Region VästerbottenTillgänglig från: 2024-12-03 Skapad: 2024-12-03 Senast uppdaterad: 2025-09-16Bibliografiskt granskad
Ingår i avhandling
1. Aspects of aneurysm epidemiology
Öppna denna publikation i ny flik eller fönster >>Aspects of aneurysm epidemiology
2025 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Background:

The Västerbotten County in Northern Sweden, and particularly Norsjö municipality, has historically had a high burden of cardiovascular disease, and abdominal aortic aneurysm (AAA).

Aims:

To investigate aspects of aneurysm epidemiology in a population with historically high cardiovascular disease and AAA incidence; specifically:(I)to study the AAA prevalence and associated risk factors in a high-risk population;(II)to study popliteal artery diameter and prevalence of popliteal artery aneurysm (PAA) in a high-risk population;(III) to study risk factors associated with the development of AAA and thoracic aortic aneurysm (TAA);(IV)to study dietary factors and risk for development of AAA and TAA.

Methods & Results:

Population-based screening in Norsjö (ages 65–75) showed a significant decline in AAA prevalence among men (16.9% in 1999 → 5.7% in 2010) and a nonsignificant decline in women (3.5% → 1.1%). Compared to 1999, lipid profiles, BMI, and blood pressure control improved, while smoking remained unchanged at low levels. PAA prevalence ≥12 mm was 3.8% in men and 0% in women; most were small and benign with slow growth rates. In a population-based case-control study, using the prospective VIP/MONICA cohort 1985–2010, smoking, hypertension, hyperlipidemia, and coronary artery disease were significantly associated with later AAA development, while only hypertension was associated with TAA development. In the same case-control cohorts, a weak inverse association between AAA and adherence to a Mediterranean diet or high fruit/vegetable intake was observed.

Conclusion:

The sharp decline in AAA prevalence in Norsjö was mainly attributed to improved cardiovascular risk factors, including diet, rather than smoking habits (as suggested in the literature). AAA and TAA show distinct risk factor profiles, indicating partly different etiologies. PAA is rare, and small screening-detected PAAs appear largely benign.

Ort, förlag, år, upplaga, sidor
Umeå: Umeå University, 2025. s. 59
Serie
Umeå University medical dissertations, ISSN 0346-6612 ; 2382
Nyckelord
Abdominal aortic aneurysm, thoracic aortic aneurysm, popliteal artery aneurysm, screening, diet, health interventions, risk factors
Nationell ämneskategori
Kirurgi
Forskningsämne
kirurgi
Identifikatorer
urn:nbn:se:umu:diva-244202 (URN)978-91-8070-796-1 (ISBN)978-91-8070-797-8 (ISBN)
Disputation
2025-10-10, Hörsal B, utbildningsnod T9, Norrlands universitetssjukhus, Umeå, 13:00 (Svenska)
Opponent
Handledare
Tillgänglig från: 2025-09-19 Skapad: 2025-09-15 Senast uppdaterad: 2025-09-17Bibliografiskt granskad

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Persson, Sven-ErikHolsti, MariWanhainen, Anders

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