Abdominal Aortic Aneurysm Events in the Women's Health Initiative: Cohort Study

Overview

Journal BMJ

Specialty General Medicine

Date 2008 Oct 16

PMID 18854591

Citations 34

Authors

Frank A Lederle

Joseph C Larson

Karen L Margolis

Matthew A Allison

Matthew S Freiberg

Barbara B Cochrane

William F Graettinger

J David Curb

Affiliations

Soon will be listed here.

Abstract

Objective: To assess the association between potential risk factors and subsequent clinically important abdominal aortic aneurysm events (repairs and ruptures) in women.

Design: Large prospective observational cohort study with mean follow-up of 7.8 years.

Setting: 40 clinical centres across the United States.

Participants: 161 808 postmenopausal women aged 50-79 enrolled in the women's health initiative.

Main Outcome Measures: Association of self reported or measured baseline variables with confirmed abdominal aortic aneurysm events assessed with multiple logistic regression.

Results: Events occurred in 184 women and were strongly associated with age and smoking. Ever smoking, current smoking, and amount smoked all contributed independent risk. Diabetes showed a negative association (odds ratio 0.29, 95% confidence interval 0.13, 0.68), as did postmenopausal hormone therapy. Positive associations were also seen for height, hypertension, cholesterol lowering treatment, and coronary and peripheral artery disease.

Conclusions: Our findings confirm the strong positive associations of clinically important abdominal aortic aneurysm with age and smoking in women and the negative association with diabetes previously reported in men.

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References

Lederle F, Johnson G, Wilson S, Chute E, Littooy F, Bandyk D . Prevalence and associations of abdominal aortic aneurysm detected through screening. Aneurysm Detection and Management (ADAM) Veterans Affairs Cooperative Study Group. Ann Intern Med. 1997; 126(6):441-9. DOI: 10.7326/0003-4819-126-6-199703150-00004. View

DeRubertis B, Trocciola S, Ryer E, Pieracci F, McKinsey J, Faries P . Abdominal aortic aneurysm in women: prevalence, risk factors, and implications for screening. J Vasc Surg. 2007; 46(4):630-635. DOI: 10.1016/j.jvs.2007.06.024. View

Lederle F, Johnson G, Wilson S, Chute E, Hye R, Makaroun M . The aneurysm detection and management study screening program: validation cohort and final results. Aneurysm Detection and Management Veterans Affairs Cooperative Study Investigators. Arch Intern Med. 2000; 160(10):1425-30. DOI: 10.1001/archinte.160.10.1425. View

Lederle F, Johnson G, Wilson S . Abdominal aortic aneurysm in women. J Vasc Surg. 2001; 34(1):122-6. DOI: 10.1067/mva.2001.115275. View

Singh K, Bonaa K, Jacobsen B, Bjork L, Solberg S . Prevalence of and risk factors for abdominal aortic aneurysms in a population-based study : The Tromsø Study. Am J Epidemiol. 2001; 154(3):236-44. DOI: 10.1093/aje/154.3.236. View

Rodin M, Daviglus M, Wong G, Liu K, Garside D, Greenland P . Middle age cardiovascular risk factors and abdominal aortic aneurysm in older age. Hypertension. 2003; 42(1):61-8. DOI: 10.1161/01.HYP.0000078829.02288.98. View

Cepeda M, Boston R, Farrar J, Strom B . Comparison of logistic regression versus propensity score when the number of events is low and there are multiple confounders. Am J Epidemiol. 2003; 158(3):280-7. DOI: 10.1093/aje/kwg115. View

Lederle F, Nelson D, Joseph A . Smokers' relative risk for aortic aneurysm compared with other smoking-related diseases: a systematic review. J Vasc Surg. 2003; 38(2):329-34. DOI: 10.1016/s0741-5214(03)00136-8. View

Hsia J, Criqui M, Rodabough R, Langer R, Resnick H, Phillips L . Estrogen plus progestin and the risk of peripheral arterial disease: the Women's Health Initiative. Circulation. 2004; 109(5):620-6. DOI: 10.1161/01.CIR.0000115309.63979.92. View

10.

Pleumeekers H, Hoes A, van der Does E, van Urk H, Hofman A, de Jong P . Aneurysms of the abdominal aorta in older adults. The Rotterdam Study. Am J Epidemiol. 1995; 142(12):1291-9. DOI: 10.1093/oxfordjournals.aje.a117596. View

11.

Kanagasabay R, Gajraj H, Pointon L, Scott R . Co-morbidity in patients with abdominal aortic aneurysm. J Med Screen. 1996; 3(4):208-10. DOI: 10.1177/096914139600300410. View

12.

Lamorte W, E Scott T, Menzoian J . Racial differences in the incidence of femoral bypass and abdominal aortic aneurysmectomy in Massachusetts: relationship to cardiovascular risk factors. J Vasc Surg. 1995; 21(3):422-31. DOI: 10.1016/s0741-5214(95)70284-9. View

13.

. Design of the Women's Health Initiative clinical trial and observational study. The Women's Health Initiative Study Group. Control Clin Trials. 1998; 19(1):61-109. DOI: 10.1016/s0197-2456(97)00078-0. View

14.

Heckbert S, Kooperberg C, Safford M, Psaty B, Hsia J, McTiernan A . Comparison of self-report, hospital discharge codes, and adjudication of cardiovascular events in the Women's Health Initiative. Am J Epidemiol. 2004; 160(12):1152-8. DOI: 10.1093/aje/kwh314. View

15.

Prentice R, Langer R, Stefanick M, Howard B, Pettinger M, Anderson G . Combined postmenopausal hormone therapy and cardiovascular disease: toward resolving the discrepancy between observational studies and the Women's Health Initiative clinical trial. Am J Epidemiol. 2005; 162(5):404-14. DOI: 10.1093/aje/kwi223. View

16.

Weiss J, Sumpio B . Review of prevalence and outcome of vascular disease in patients with diabetes mellitus. Eur J Vasc Endovasc Surg. 2005; 31(2):143-50. DOI: 10.1016/j.ejvs.2005.08.015. View

17.

Hsia J, Criqui M, Herrington D, Manson J, Wu L, Heckbert S . Conjugated equine estrogens and peripheral arterial disease risk: the Women's Health Initiative. Am Heart J. 2006; 152(1):170-6. DOI: 10.1016/j.ahj.2005.09.005. View

18.

Wong D, Willett W, Rimm E . Smoking, hypertension, alcohol consumption, and risk of abdominal aortic aneurysm in men. Am J Epidemiol. 2007; 165(7):838-45. DOI: 10.1093/aje/kwk063. View

19.

McPhee J, Hill J, Eslami M . The impact of gender on presentation, therapy, and mortality of abdominal aortic aneurysm in the United States, 2001-2004. J Vasc Surg. 2007; 45(5):891-9. DOI: 10.1016/j.jvs.2007.01.043. View

20.

Norman P, Davis T, Le M, Golledge J . Matrix biology of abdominal aortic aneurysms in diabetes: mechanisms underlying the negative association. Connect Tissue Res. 2007; 48(3):125-31. DOI: 10.1080/03008200701331524. View