Risk factors for abdominal aortic aneurysms in older adults enrolled in the cardiovascular health study
Risk factors for abdominal aortic aneurysms in older adults enrolled in the cardiovascular health study
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DOI：
10.1161/01.atv.16.8.963
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发表时间：
1996-08-01
影响因子：
8.7
通讯作者：
OLeary, D
中科院分区：
文献类型：
--
作者：
Alcorn, HG;Wolfson, SK;OLeary, D
从1990年到1992年进行了腹主动脉的B型超声检查，以评估腹主动脉瘤（AAA）在心血管健康研究（CHS）匹兹堡队列（656名参与者，年龄65 - 90岁）的一个亚组中的患病率。在这项初步研究中，我们评估了动脉瘤的各种定义和测量的可重复性。在第5年（1992年至1993年）的CHS，整个队列（4741名参与者）进行了检查。AAA定义为肾下主动脉直径大于或等于3.0 cm，或肾下与肾上直径之比大于或等于1.2，或有AAA修复史。对于整个CHS队列，动脉瘤的患病率总体为9.5%（451/4741），男性患病率为14.2%（278/ 1956），女性患病率为6.2%（173/2785）。与AAA显著相关的变量包括年龄较大、男性、心绞痛、冠心病和心肌梗死病史、踝臂血压比较低、颈动脉最大狭窄程度较高、颈内动脉内膜中层厚度较大、肌酐较高、HDL水平较低和LDL水平较高以及吸烟。该研究记录了心血管危险因素与临床和亚临床动脉粥样硬化和心血管疾病以及动脉瘤患病率的密切相关性。我们使用的定义比以前报道的（直径或比率）更敏感，这允许检测较小的动脉瘤，可能是那些处于早期发展阶段的动脉瘤。该队列的随访可能会导致确定动脉瘤进展风险因素的新标准。
B-mode ultrasound examinations of the abdominal aorta were performed from 1990 to 1992 to evaluate the prevalence of abdominal aortic aneurysm (AAA) in a subgroup of the Pittsburgh cohort (656 participants, aged 65 to 90 years) of the Cardiovascular Health Study (CHS). In this pilot study, we evaluated various definitions of aneurysm and the reproducibility of the measurements. In year 5 (1992 to 1993) of the CHS, the entire cohort (4741 participants) was examined. AAA was defined as an infrarenal aortic diameter of greater than or equal to 3.0 cm, or a ratio of infrarenal to suprarenal diameter of greater than or equal to 1.2, or a history of AAA repair. For the entire CHS cohort, prevalence of aneurysms was 9.5% (451/4741) overall, with a prevalence among men of 14.2% (278/ 1956) and prevalence among women of 6.2% (173/2785). Variables significantly related to AAA were older age; male sex; history of angina, coronary heart disease, and myocardial infarction; lower ankle-arm blood pressure ratio; higher maximum carotid stenosis; greater intima-media thickness of the internal carotid artery; higher creatinine; lower HDL levels and higher LDL levels; and cigarette smoking. The study has documented the strong association of cardiovascular risk factors and measures of clinical and subclinical atherosclerosis and cardiovascular disease and prevalence of aneurysms. We used a definition that is more sensitive than previously reported (diameter or ratio), which allowed the detection of smaller aneurysms and possibly those at an earlier stage of development. Follow-up of this cohort may lead to new criteria for determining the risk factors for progression of aneurysms.