Smoking, sex, risk factors and abdominal aortic aneurysms: a prospective study of 18 782 persons aged above 65 years in the Southern Community Cohort Study

Jahangir, Eiman, Lipworth, Loren, Edwards, Todd L., Kabagambe, Edmond K., Mumma, Michael T., Mensah, George A., Fazio, Sergio, Blot, William J. and Sampson, Uchechukwu K. A. (2015) Smoking, sex, risk factors and abdominal aortic aneurysms: a prospective study of 18 782 persons aged above 65 years in the Southern Community Cohort Study. Journal of Epidemiology and Community Health, 69 5: 481-488. doi:10.1136/jech-2014-204920


Author Jahangir, Eiman
Lipworth, Loren
Edwards, Todd L.
Kabagambe, Edmond K.
Mumma, Michael T.
Mensah, George A.
Fazio, Sergio
Blot, William J.
Sampson, Uchechukwu K. A.
Title Smoking, sex, risk factors and abdominal aortic aneurysms: a prospective study of 18 782 persons aged above 65 years in the Southern Community Cohort Study
Journal name Journal of Epidemiology and Community Health   Check publisher's open access policy
ISSN 0143-005X
1470-2738
Publication date 2015-05
Sub-type Article (original research)
DOI 10.1136/jech-2014-204920
Open Access Status Not yet assessed
Volume 69
Issue 5
Start page 481
End page 488
Total pages 8
Place of publication London, United Kingdom
Publisher B M J Group
Collection year 2016
Language eng
Formatted abstract
Background: Abdominal aortic aneurysm (AAA) is a leading cause of death in the USA. We evaluated the incidence and predictors of AAA in a prospectively followed cohort.

Methods: We calculated age-adjusted AAA incidence rates (IR) among 18 782 participants aged ≥65 years in the Southern Community Cohort Study who received Medicare coverage from 1999–2012, and assessed predictors of AAA using multivariable Cox proportional hazards models, overall and stratified by sex, adjusting for demographic, lifestyle, socioeconomic, medical and other factors. HRs and 95% CIs were calculated for AAA in relation to factors ascertained at enrolment.

Results: Over a median follow-up of 4.94 years, 281 cases were identified. Annual IR was 153/100 000, 401, 354 and 174 among blacks, whites, men and women, respectively. AAA risk was lower among women (HR 0.48, 95% CI 0.36 to 0.65) and blacks (HR 0.51, 95% CI 0.37 to 0.69). Smoking was the strongest risk factor (former: HR 1.91, 95% CI 1.27 to 2.87; current: HR 5.55, 95% CI 3.67 to 8.40), and pronounced in women (former: HR 3.4, 95% CI 1.83 to 6.31; current: HR 9.17, 95% CI 4.95 to 17). A history of hypertension (HR 1.44, 95% CI 1.04 to 2.01) and myocardial infarction or coronary artery bypass surgery (HR 1.9, 95% CI 1.37 to 2.63) was negatively associated, whereas a body mass index ≥25 kg/m2 (HR 0.72; 95% CI 0.53 to 0.98) was protective. College education (HR 0.6, 95% CI 0.37 to 0.97) and black race (HR 0.44, 95% CI 0.28 to 0.67) were protective among men.

Conclusions: Smoking is a major risk factor for incident AAA, with a strong and similar association between men and women. Further studies are needed to evaluate benefits of ultrasound screening for AAA among women smokers.
Keyword Cost effectiveness
Older adults
Mortality
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Medicine Publications
 
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