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IJE Advance Access published online on November 5, 2009
International Journal of Epidemiology, doi:10.1093/ije/dyp320
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2009; all rights reserved.
The online version of this article has been published under an open access model. Users are entitled to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that: the original authorship is properly and fully attributed; the Journal and Oxford University Press are attributed as the original place of publication with the correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions@oxfordjournals.org

Abdominal aortic aneurysms, or a relatively large diameter of non-aneurysmal aortas, increase total and cardiovascular mortality: the Tromsø study

Signe Helene Forsdahl1,*, Steinar Solberg2, Kulbir Singh3 and Bjarne K Jacobsen1

1 Department of Community Medicine, University of Tromsø, Tromsø, Norway.
2 Department of Thoracic and Cardiovascular Surgery, Rikshospitalet, Oslo, Norway.
3 Department of Radiology, University Hospital of North Norway, Tromsø, Norway.

* Corresponding author. Department of Community Medicine, University of Tromsø, 9037 Tromsø, Norway. E-mail: signe.helene.forsdahl{at}uit.no


  Abstract

Background In a population-based study in Tromsø, Norway, the authors assessed whether an abdominal aortic aneurysm (AAA) or the maximal infrarenal aortic diameter in a non-aneurismal aorta influence total and cardiovascular disease (CVD) mortality.

Methods A total of 6640 men and women, aged 25–84 years, were included in a 10-year mortality follow-up: 345 subjects with a diagnosed AAA and 6295 subjects with a non-aneurismal aorta. Non-aneurismal aortic diameter and prevalent AAAs were categorized into seven groups.

Results In subjects without an AAA, an aortic diameter ≥30 mm increased age- and sex-adjusted total mortality [mortality rate ratio (MRR) = 3.73, 95% confidence interval (CI) 1.77–7.89] and CVD mortality (MRR = 9.24, 95% CI 4.07–20.97) compared with subjects with aortic diameter of 21–23 mm. An AAA at screening was strongly associated with deaths from aortic aneurysm and was associated with total (MRR = 1.60, 95% CI 1.31–1.96) and CVD mortality (MRR = 2.41, 95% CI 1.81–3.21). This was not explained by deaths due to an AAA. Adjustments for CVD risk factors could fully explain the increased total, but not CVD mortality in subjects with an AAA.

Conclusions An AAA increases total and CVD mortality. In the large majority of subjects with a non-aneurysmal aorta, the diameter does not influence total or CVD mortality. However, in individuals with a maximal diameter >26 mm (2% of the population), a positive relationship is found.

Keywords Epidemiology, prospective cohort study, abdominal aortic aneurysm, total mortality, cardiovascular mortality, ultrasonography

Accepted 24 September 2009


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