EPIDEMIOLOGY AND POTENTIAL FOR PREVENTION OF ABDOMINAL AORTIC-ANEURYSM

Background Ruptured abdominal aortic aneurysm (AAA) is a common cause of death which is preventable by elective repair of an asymptomatic AA A. Methods The literature was reviewed with emphasis on epidemiologica l studies and population-based screening surveys. Results and Conclusi on The prevalence of small AAA ranges between 3 and 8 per cent. The in cidence of asymptomatic AAA seems to be increasing, although exact inc idence estimates vary. The most important risk factors for AAA are mal e sex, age, family history and smoking. Hypertension is associated wit h a mildly increased risk, but diabetes is not associated with any inc rease. Primary prevention of AAA is not a realistic option. There is n o evidence of an effective medical treatment to prevent growth of smal l AAAs, although trials with propranolol are under way. The only inter vention to prevent death from aneurysm is elective repair of the asymp tomatic lesion. Screening for asymptomatic AAA can reduce the incidenc e of rupture. However, further studies are needed to determine the cos t effectiveness of screening compared with that of other health progra mmes.