Published Online
on June 9, 2003

A more recent version of this article appeared on July 1, 2003

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Submitted on July 23, 2002
Revised on August 27, 2002

Middle Age Cardiovascular Risk Factors and Abdominal Aortic Aneurysm in Older Age

Miriam B. Rodin; Martha L. Daviglus; Gordon C. Wong; Kiang Liu; Daniel B. Garside; Philip Greenland; and Jeremiah Stamler^*

From the Division of Geriatrics, Department of Medicine, University of Chicago Pritzker School of Medicine (M.B.R.), Chicago; the Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University (M.L.D., K.L., D.B.G., P.G., J.S.), Chicago, Illinois; and the Department of Medicine, St. Mary's Medical Center (G.C.W.), San Francisco, California.

^* To whom correspondence should be addressed. E-mail: hwe216{at}northwestern.edu.

Abstract--Few prospective studies have examined associations between major cardiovascular risk factors and occurrence of abdominal aortic aneurysm; findings from cross-sectional studies are inconsistent. This long-term population-based study assessed relationships of major risk factors in middle-age to clinical nonfatal plus fatal abdominal aortic aneurysm in older-age in the Chicago Heart Association Detection Project in Industry cohort--10 574 men and 8700 women baseline ages 40 to 64 years screened for risk factors in 1967-1973 at workplaces. With average follow-up of 30 years and clinical cases identified from Medicare records and death certificates, risk factor relationships to abdominal aortic aneurysm occurrence were assessed by Cox regression. There were among men 309 cases and among women, 109--most from Medicare records. Most findings were qualitatively similar for men and women. In multivariate analyses (5 models), hazard ratios for abdominal aortic aneurysm were significantly greater for men than women (1.97), with older age (1.63/5 years), higher serum cholesterol (1.30/40.0 mg/dL), cigarettes/d (2.43/20 cigarettes), past smoking (1.41), height (1.17/7 cm), evidence of adverse blood pressure (hazard ratio 1.10/20 mm Hg higher systolic pressure, 1.12 to 1.14/12 mm Hg higher diastolic pressure, 1.87 with history of treated hypertension). It is concluded that major cardiovascular risk factors--serum cholesterol, smoking, and blood pressure--in middle age relate significantly to risk of abdominal aortic aneurysm in persons surviving into older age.

Key words: abdominal aortic aneurysm • risk factors • prospective studies • blood pressure • cholesterol • smoking

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