The Aneurysm Detection and Management study screening program: Validation cohort and final results

Frank A. Lederle, Gary R. Johnson, Samuel E. Wilson, Edmund P. Chute, Robert J. Hye, Michel S. Makaroun, Gary W. Barone, Dennis Bandyk, Gregory L. Moneta, Raymond G. Makhoul

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    484 Scopus citations


    Background: We previously reported the prevalence and associations of abdominal aortic aneurysm (AAA) in 73451 veterans aged 50 to 79 years who underwent ultrasound screening. Objective: To understand the prevalence of and principal positive and negative risk factors for AAA, and to assess reproducibility of our previous findings. Methods: In the new cohort of veterans undergoing screening, 52745 subjects aged 50 to 79 without history of AAA underwent successful ultrasound screening for AAA, after completing a questionnaire on demographics and potential risk factors. Results: We detected AAA of 4.0 cm or larger in 613 participants (1.2%; compared with 1.4% in the earlier cohort). The direction and magnitude of the important associations reported in the first cohort were confirmed. Respective odds ratios for the major associations with AAA for the second and for the combined cohorts were as follows: 1.81 and 1.71 for age (per 7 years), 0.12 and 0.18 for female sex, 0.59 and 0.53 for black race, 1.94 and 1.94 for family history of AAA, 4.45 and 5.07 for smoking, 0.50 and 0.52 for diabetes, and 1.60 and 1.66 for atherosclerotic diseases. The excess prevalence associated with smoking accounted for 75% of all AAAs of 4.0 cm or larger in the total population of 126196. Associations for AAA of 3.0 to 3.9 cm were similar but tended to be somewhat weaker. Conclusions: Our findings confirm our previous cohort findings. Age, smoking, family history of AAA, and atherosclerotic diseases remained the principal positive associations with AAA, and female sex, diabetes, and black race remained the principal negative associations.

    Original languageEnglish (US)
    Pages (from-to)1425-1430
    Number of pages6
    JournalArchives of internal medicine
    Issue number10
    StatePublished - May 22 2000

    ASJC Scopus subject areas

    • Internal Medicine

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