Alcorn H G, Wolfson S K, Sutton-Tyrrell K, Kuller L H, O'Leary D
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA 15261, USA.
Arterioscler Thromb Vasc Biol. 1996 Aug;16(8):963-70. doi: 10.1161/01.atv.16.8.963.
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 > or= 3.0 cm, or a ratio of infrarenal to suprarenal diameter of > or= 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.
1990年至1992年期间，对心血管健康研究（CHS）匹兹堡队列中的一个亚组（656名年龄在65至90岁之间的参与者）进行了腹主动脉的B超检查，以评估腹主动脉瘤（AAA）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以及测量的可重复性。在CHS的第5年（1992年至1993年），对整个队列（4741名参与者）进行了检查。AAA的定义为肾下腹主动脉直径≥3.0厘米，或肾下与肾上直径之比≥1.2，或有AAA修复史。对于整个CHS队列，动脉瘤的总体患病率为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；有心绞痛、冠心病和心肌梗死病史；较低的踝臂血压比；较高的最大颈动脉狭窄程度；颈内动脉内膜中层厚度较大；肌酐水平较高；高密度脂蛋白水平较低和低密度脂蛋白水平较高；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及心血管疾病测量指标以及动脉瘤患病率之间的密切关联。我们使用了一种比以前报告的定义更敏感的定义（直径或比率），这使得能够检测到更小的动脉瘤，可能还有处于发展早期阶段的动脉瘤。对该队列的随访可能会产生确定动脉瘤进展危险因素的新标准。
