SCREENING FOR ABDOMINAL AORTIC-ANEURYSMS IN A HYPERTENSIVE PATIENT POPULATION

Background: Abdominal aortic aneurysm (AAA) is an important cause of p reventable death in the elderly. Objective: To search for an effective screening program for the detection of AAA. Methods: We consecutively and prospectively screened 240 male, predominantly white, patients, a ged 60 to 75 years, by ultrasound for the presence of AAA in 2 phases: in screen 1, hypertension (diastolic blood pressure reading >95 mm Hg ) was the only selection criterion; in screen 2, we included hypertens ive patients with a systolic blood pressure level higher than 175 mm H g with or without antihypertensive therapy, transient ischemic attacks and/or stroke, and claudication. Results: The yield of AAAs in screen s 1 and 2 was 3% and 11%, respectively (P<.02, chi(2) analysis). No AA As were found in patients with uncomplicated hypertension. Of the card iovascular complications, only claudication was independently associat ed with the presence of AAA (relative risk, 5.8; confidence interval, 1.8-18.6; P=.004). Conclusions: Screening for AAA is recommended for e lderly white patients with claudication. Uncomplicated hypertension by itself is not an indication for screening.