Traditional and Novel Risk Factors for Clinically Diagnosed Abdominal Aortic Aneurysm: The Kaiser Multiphasic Health Checkup Cohort Study

Carlos Iribarren, Jeanne A. Darbinian, Alan S. Go, Bruce H. Fireman, Chong D. Lee, Douglas P. Grey

Research output: Contribution to journalArticle

97 Scopus citations

Abstract

Background: Identification of risk factors for and early diagnosis of clinically significant abdominal aortic aneurysm (AAA) before rupture is vital to optimize outcomes in these patients. Our aim was to examine traditional and three novel potential risk factors (abdominal obesity, white blood cell count, and kidney function) for abdominal aortic aneurysm (AAA, comprising discharge diagnosis or surgical repair) in a large multiethnic population. Methods: Cohort study (N =104,813) conducted at an integrated health care delivery system in northern California. Results: After a median of 13 years, 605 AAA events (490 in men and 115 in women; 91 [15%] fatal) were observed. In multivariable analysis, factors significantly associated with risk of clinically detected AAA included male gender, older age, black race (inversely), low educational attainment, cigarette smoking (with dose-response relation), height, treated and untreated hypertension, high total serum cholesterol, elevated white blood cell count, known coronary artery disease, history of intermittent claudication, and reduced kidney function. A significant Asian race by gender interaction was found such that Asian race had a (borderline significant) protective association with AAA in men but not in women. Conclusions: Our findings confirm that major atherosclerotic risk factors, except for diabetes and obesity, are also prospectively related to AAA and suggest that elevated white blood cell count and reduced kidney function may improve risk stratification for clinically relevant AAA.

Original languageEnglish (US)
Pages (from-to)669-678
Number of pages10
JournalAnnals of Epidemiology
Volume17
Issue number9
DOIs
StatePublished - Sep 1 2007
Externally publishedYes

Keywords

  • Aortic Aneurysm/Epidemiology
  • Cohort Study
  • Risk Factors

ASJC Scopus subject areas

  • Epidemiology

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