Unravelling the familial tendency to aneurysmal disease: Popliteal aneurysm, hypertension and fibrillin genotype

• Published in: European journal of vascular and endovascular surgery 1996-08, Vol.12 (2), p.162-166
• Main Authors: MacSweeney, S.T.R., Skidmore, C., Turner, R.J., Sian, M., Brown, L., Henney, A.M., Greenhalgh, R.M., Powell, J.T.
• Format: Article
• Language: English
• Subjects: Age Factors; Aged; Aneurysm; Aneurysm - epidemiology; Aneurysm - genetics; Aneurysm - prevention & control; Aortic Aneurysm, Abdominal - epidemiology; Aortic Aneurysm, Abdominal - genetics; Apolipoproteins B - genetics; Body Height; Collagen - genetics; Extracellular Matrix Proteins - genetics; Female; Fibrillin; Fibrillin-1; Fibrillins; Genotype; Humans; Hypertension; Hypertension - epidemiology; Hypertension - genetics; Male; Mass Screening; Microfilament Proteins - genetics; Popliteal Artery; Regression Analysis; Risk Factors; Triglycerides; Triglycerides - blood
• ISSN: 1078-5884; 1532-2165
• DOI: 10.1016/S1078-5884(96)80101-8

To screen patients with abdominal aortic aneurysm for popliteal aneurysm and investigate cardiovascular and genetic risk factors associated with aneurysmal disease at more than one site (generalised aneurysmal disease). All patients referred to the Regional Vascular Surgical Service at Charing Cross Hospital with unruptured abdominal aortic aneurysm between 1989 and 1993 were screened for popliteal aneurysms, using ultrasonography. Palpation of a popliteal aneurysm or ultrasonographic detection of popliteal dilatation, where the ratio maximum popliteal fossa diameter/suprageniculate popliteal diameter was ≥ 1.5, in relation to cardiovascular and genetic risk factors. Clinical examination detected popliteal aneurysms in only 11/232 patients (5%), but ultrasonography demonstrated the presence of popliteal aneurysm in a further 13 patients, 24/232 in total (10%). Multivariate regression identified four independent factors associated with popliteal dilatation disease : age ( p = 0.046), height ( p = 0.006), systolic hypertension (p = 0.037) and triglyceride concentration (p = 0.009). Generalised aneurysmal disease and systolic blood pressure were associated with polymorphic variation in the fibrillin-1 gene, but not with variations in the apolipoprotein B and type III collagen genes. Few patients with abdominal aortic aneurysm (10%) also have popliteal aneurysms: the risk of popliteal dilatation increases with age, height, systolic blood pressure, triglyceride concentration and fibrillin genotype. The strong interaction between fibrillin genotype and blood pressure may contribute to the familial tendency to aortic aneurysm.