Cardiovascular disease and mortality in older adults with small abdominal aortic aneurysms detected by ultrasonography: the Cardiovascular Health Study.

A bdominal aortic aneurysms (AAA) are a common condition found in at least 3% of the population aged over 50 years and, in this study, 9% of those over 65. The mortality of AAA rupture is significant and up to one half of the perioperative deaths are due to myocardial infarctions. The Cardiovascular Health Study was designed to identify risk factors for development and progression of cardiovascular disease, including AAA in older adults. The primary goal of this study was to evaluate whether the risks for mortality and cardiovascular disease associated with abdominal aneurysms were related to higher levels of risk factors and greater extent of vascular disease on noninvasive testing. The Cardiovascular Health Study was a random, multicenter study of men and women older than 65. Patients were excluded if they were considered disabled, were institutionalized, or had cancer. The risk for mortality and incident cardiovascular events was assessed over a 4.5-year period. AAA were defined as an infrarenal aorta diameter of >3.0 centimeters, or an infrarenal:suprarenal ratio of >1.2. Risk factors for cardiovascular disease included cigarette smoking, hypertension, diabetes, sibling history of myocardial infarction or stroke, and lipid levels. The extent of vascular disease was assessed noninvasively by carotid ultrasound, ankle:arm index, and standard 12-lead electrocardiogram (ECG). Outcomes measured were total mortality from cardiac and noncardiac causes, incident cardiovascular disease, recurrent cardiovascular disease, and repair or rupture of AAA. Cardiovascular disease morbidity and mortality included any death or incident related to cardiovascular disease.