Persson Sven-Erik, Boman Kurt, Wanhainen Anders, Carlberg Bo, Arnerlöv Conny
Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden.
Department of Medicine, Skellefteå County Hospital, Skellefteå, Sweden.
J Vasc Surg. 2017 Mar;65(3):651-658. doi: 10.1016/j.jvs.2016.08.091. Epub 2016 Oct 25.
A significant reduction in the incidence of cardiovascular disease, including abdominal aortic aneurysm (AAA), has been observed in the past decades. In this study, a small but geographically well defined and carefully characterized population, previously screened for AAA and risk factors, was re-examined 11 years later. The aim was to study the reduction of AAA prevalence and associated factors.
All men and women aged 65 to 75 years living in the Norsjö municipality in northern Sweden in January 2010 were invited to an ultrasound examination of the abdominal aorta, registration of body parameters and cardiovascular risk factors, and blood sampling. An AAA was defined as an infrarenal aortic diameter ≥30 mm. Results were compared with a corresponding investigation conducted in 1999 in the same region.
A total of 602 subjects were invited, of whom 540 (90%) accepted. In 2010, the AAA prevalence was 5.7% (95% confidence interval [CI], 2.8%-8.5%) among men compared with 16.9% (95% CI, 12.3%-21.6%) in 1999 (P < .001). The corresponding figure for women was 1.1% (95% CI, 0.0%-2.4%) vs 3.5% (95% CI, 1.2%-5.8%; P = .080). A low prevalence of smoking was observed in 2010 as well as in 1999, with only 13% and 10% current smokers, respectively (P = .16). Treatment for hypertension was significantly more common in 2010 (58% vs 44%; P < .001). Statins increased in the population (34% in 2010 vs 3% in 1999; P < .001), and the lipid profile in women had improved significantly between 1999 and 2010.
A highly significant reduction in AAA prevalence was observed during 11 years in Norsjö. Treatment for hypertension and with statins was more frequent, whereas smoking habits remained low. This indicates that smoking is not the only driver behind AAA occurrence and that lifestyle changes and treatment of cardiovascular risk factors may play an equally important role in the observed recent decline in AAA prevalence.
在过去几十年中，已观察到心血管疾病（包括腹主动脉瘤（AAA））的发病率显著降低。在本研究中，对一个规模较小但地理位置明确且特征明确的人群进行了重新检查，该人群此前已接受过AAA及危险因素筛查，此次复查是在11年后进行的。目的是研究AAA患病率的降低情况及相关因素。
邀请了2010年1月居住在瑞典北部诺尔雪平市的所有65至75岁男性和女性参加腹主动脉超声检查、身体参数和心血管危险因素登记以及血液采样。AAA定义为肾下腹主动脉直径≥30mm。将结果与1999年在同一地区进行的相应调查进行比较。
共邀请了602名受试者，其中540名（90%）接受了邀请。2010年，男性的AAA患病率为5.7%（95%置信区间[CI]，2.8%-8.5%），而1999年为16.9%（95%CI，12.3%-21.6%）（P<.001）。女性的相应数字分别为1.1%（95%CI，0.0%-2.4%）和3.5%（95%CI，1.2%-5.8%；P=.080）。2010年和1999年吸烟率均较低，目前吸烟者分别仅为13%和10%（P=.16）。2010年高血压治疗明显更为普遍（58%对44%；P<.001）。人群中他汀类药物的使用增加（2010年为34%，1999年为3%；P<.001），1999年至2010年间女性的血脂状况有显著改善。
在诺尔雪平市的11年期间，观察到AAA患病率显著降低。高血压治疗和他汀类药物的使用更为频繁，而吸烟习惯仍然较低。这表明吸烟不是AAA发生的唯一驱动因素，生活方式的改变和心血管危险因素的治疗在近期观察到的AAA患病率下降中可能发挥同样重要的作用。
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