Aortic aneurysms in a general population cohort: prevalence and risk factors in men and women

• Published in: European heart journal cardiovascular imaging 2024-08, Vol.25 (9), p.1235-1243
• Main Authors: Pham, Michael Huy Cuong, Sigvardsen, Per Ejlstrup, Fuchs, Andreas, Kühl, Jørgen Tobias, Sillesen, Henrik, Afzal, Shoaib, Nordestgaard, Børge Grønne, Køber, Lars Valeur, Kofoed, Klaus Fuglsang
• Format: Article
• Language: English
• ISSN: 2047-2404; 2047-2412; 2047-2412
• DOI: 10.1093/ehjci/jeae103

Abstract Aims The prevalence and difference in risk factors for having thoracic aortic aneurysm (TAA) and abdominal aortic aneurysm (AAA) in men compared with women in the general population is not well described. This study aimed to test the hypotheses that (i) cardiovascular risk factors for TAA and AAA differ and (ii) the prevalence of TAA and AAA is sex specific. Methods and results Aortic examination using computed tomography angiography was performed in 11 294 individuals (56% women), with a mean age of 62 (range 40–95) years participating in the Copenhagen General Population Study. TAAs were defined as an ascending aortic diameter ≥45 mm and a descending aortic diameter ≥35 mm, while AAAs were defined as an abdominal aortic diameter ≥30 mm. Demographic data were obtained from questionnaires. Overall prevalence of aortic aneurysms (AAs) in the study population included: total population 2.1%, men 4.0% and women 0.7% (P-value men vs. women P < 0.001). AAs were independently associated with male sex, increasing age, and body surface area (BSA). While TAAs were associated with hypertension, odds ratio (OR) = 2.0 [95% confidence interval (CI): 1.5–2.8], AAAs were associated with hypercholesterolaemia and smoking, OR = 2.4 (95% CI: 1.6–3.6) and 3.2 (95% CI: 1.9–5.4). Conclusion Subclinical AAs are four times more prevalent in men than in women. In both sexes, increasing age and BSA are risk factors for AAs of any anatomical location. Whereas arterial hypertension is a risk factor for TAAs, hypercholesterolaemia and smoking are risk factors for AAAs. Structured Graphical Abstract Structured Graphical Abstract Risk factors for and prevalence of thoracic aortic aneurysm and abdominal aortic aneurysm (AAA). The width of risk factor bars at each aortic location represents the odds ratio for ascending aortic aneurysm (AA), descending AA, and AAA. The right side of the illustration depicts the different AA locations and the prevalence stratified by sex.