Does the Mediterranean paradox extend to abdominal aortic aneurysm?

Background We sought to test, in men Undergoing ultrasound screening for ab dominal aortic aneurysms (AAA) in Western Australia, clinical impressions t hat the prevalence of AAA is high in Dutch migrants and low in migrants fro m Mediterranean countries. Methods In a. population-based trial, men undergoing screening for AAA comp leted a questionnaire covering their place of birth, smoking habits and con sumption of alcohol, meat, fish, salt and milk. We examined the variation b y place of birth in the mean, median, 95th and 99th centiles of infrarenal aortic diameter and the prevalences of AAA defined by criteria of 30 mm, 50 mm and by the 95th and 99th centiles, in men born in Australia, of aortic diameter adjusted for height. Findings Overall, 12 203 (70.5%) of the 19 583 men took up the invitation t o undergo ultrasound screening. The prevalence of AAA defined by absolute d iameter was higher than average in men born in The Netherlands or Scotland (more of whom had ever smoked or smoked currently) and lower in men of Medi terranean origin (more of whom drank alcohol currently). There were no cons istent relationships with simple dietary: data. Correction of aortic diamet er for height eliminated the significant heterogeneity in prevalence of lar ge AAA, although a threefold variation in prevalence of AAA exceeding the 9 5th centile of height-adjusted diameter in Australian men persisted. Interpretation In our cohort of men, which is subject to both 'healthy migr ant' and 'survivor' effects, if it exists at all, any 'Mediterranean parado x' for AAA is more modest than that for coronary disease.