03361nas a2200385 4500008004100000022001400041245015700055210006900212260001600281300001100297490000800308520223600316653000902552653002202561653003102583653001902614653002802633653002402661653001102685653001102696653001402707653002502721653000902746653001402755653003202769653001702801653002002818653001802838100001702856700001702873700001602890700001702906700001702923856003502940 2001 eng d a0003-481900aCardiovascular disease and mortality in older adults with small abdominal aortic aneurysms detected by ultrasonography: the cardiovascular health study.0 aCardiovascular disease and mortality in older adults with small  c2001 Feb 06 a182-900 v1343 a

BACKGROUND: Persons with abdominal aortic aneurysm are more likely to have a higher prevalence of risk factors for and clinical manifestations of cardiovascular disease. It is unknown whether these factors explain the high mortality rate associated with abdominal aortic aneurysm.

OBJECTIVE: To describe the risk for mortality, cardiovascular mortality, and cardiovascular morbidity in persons screened for abdominal aortic aneurysm.

DESIGN: Longitudinal cohort study.

SETTING: Four communities in the United States.

PARTICIPANTS: 4734 men and women older than 65 years of age recruited from Medicare eligibility lists.

MEASUREMENTS: Abdominal ultrasonography was used to measure the aortic diameter and the ratio of infrarenal to suprarenal measurement of aortic diameter in 1992-1993. Abdominal aortic aneurysm was defined as aortic diameter of 3 cm or greater or infrarenal-to-suprarenal ratio of 1.2 or greater. Mortality, cardiovascular disease mortality, incident cardiovascular disease, and repair or rupture were assessed after 4.5 years.

RESULTS: The prevalence of aneurysm was 8.8%, and 87.7% of aneurysms were 3.5 cm or less in diameter. Rates of total mortality (65.1 vs. 32.8 per 1000 person-years), cardiovascular mortality (34.3 vs. 13.8 per 1000 person-years), and incident cardiovascular disease (47.3 vs. 31.0 per 1000 person-years) were higher in participants with aneurysm than in those without aneurysm; after adjustment for age, risk factors, and presence of other cardiovascular disease, the respective relative risks were 1.32, 1.36, and 1.57. Rates of repair and rupture were low.

CONCLUSIONS: Rates of total mortality, cardiovascular disease mortality, and incident cardiovascular disease were higher in participants with abdominal aortic aneurysm than in those without aneurysm, independent of age, sex, other clinical cardiovascular disease, and extent of atherosclerosis detected by noninvasive testing. Persons with smaller aneurysms detected by ultrasonography should be advised to modify risk factors for cardiovascular disease while under surveillance for increase in the size of the aneurysm.

10aAged10aAged, 80 and over10aAortic Aneurysm, Abdominal10aAortic Rupture10aCardiovascular Diseases10aDisease Progression10aFemale10aHumans10aIncidence10aLongitudinal Studies10aMale10aMortality10aProportional Hazards Models10aRisk Factors10aUltrasonography10aUnited States1 aNewman, A, B1 aArnold, A, M1 aBurke, G, L1 aO'Leary, D H1 aManolio, T A uhttps://chs-nhlbi.org/node/630