Risk Factors for Abdominal Aortic Aneurysm in the Korean Population

Abstract

Ultrasound screening shows a clinical benefit in reducing abdominal aortic aneurysm (AAA)-related mortality. However, its cost-effectiveness remains unclear. Understanding the relationship between risk factors and AAA is important to maximize the benefit of AAA screening. However, risk factors for AAA have not been reported in Korea. The purpose of this study is to determine the prevalence of, and risk factors for, AAA among the Korean population. The study population consisted of patients >50years of age who consented for AAA screening. Screening was performed as follows for all participants: collection of demographic information, including risk factors, physical examination, and ultrasound screening. We measured the maximal diameter of the aorta from the outer to outer layer at 5 levels: suprarenal, renal, and infrarenal aorta, and bilateral common iliac arteries. AAA was defined as maximal aortic diameter >3cm. The risk factors and risk ratio for AAA were determined. Chi-square test and a logistic regression model were used for statistical analysis. All P-values <0.05 were considered significant. A total of 2,035 participants were enrolled. Among them, 908 (44.6%) were men and 1,127 (55.4%) were women. Mean age was 66.9±10.3 years (range 23-95). AAA was detected in 18 of 908 (2.0%) men and 4 of 1,127 (0.4%) women. The presence of an AAA was significantly correlated with male sex (P<0.001), advanced age (P=0.01), smoking (P<0.001), alcohol consumption (P<0.01), and the presence of pulmonary disease (P=0.01). Multivariate analysis revealed that smoking was the only significant risk factor for AAA. The prevalence of AAA was 2.0% in men and 0.4% in women. Male sex, old age, smoking, alcohol use, and pulmonary disease are possible risk factors for AAA in the general Korean population. Smoking is the strongest risk factor for the development of AAA.