From the Guidelines
Yes, a family history of abdominal aortic aneurysm (AAA) does increase the risk of vascular disease in the brain.
Key Points
- Individuals with first-degree relatives who have had AAA are at higher risk for developing cerebrovascular disorders, including intracranial aneurysms and stroke 1.
- The shared risk factors include connective tissue disorders, hypertension, smoking, and genetic variants that affect vascular wall integrity.
- Conditions like Marfan syndrome, Ehlers-Danlos syndrome, and polycystic kidney disease increase risk for both AAA and cerebral aneurysms.
- A study found that 4% (95% CI, 2.6%–5.8%) of first-degree relatives of those with a history of subarachnoid hemorrhage (SAH) were found to have an unruptured intracranial aneurysm (UIA) on screening imaging 1.
Risk Factors
- Older age
- Female sex
- Cigarette smoking
- History of hypertension
- Higher lipid levels
- Higher fasting glucose
- Family history of polycystic kidney disease
- Family history of SAH or aneurysm in ≥ 2 relatives
Recommendations
- Patients with a family history of AAA should inform their healthcare providers, maintain good blood pressure control, avoid smoking, and may benefit from appropriate vascular imaging studies depending on their individual risk profile and symptoms.
- Comprehensive vascular screening is important for individuals with a family history of AAA.
- The inheritance patterns of intracranial aneurysms (IAs) are unclear, but autosomal dominance transmission is suspected to be the most common mode of inheritance 1.
- Genome-wide association studies identified replicated associations on several chromosomes, with the strongest evidence for the CDKN2BAS and SOX17 genes 1.
From the Research
Family History and Vascular Disease Risk
- A family history of abdominal aortic aneurysm (AAA) has been associated with an increased risk of vascular disease, including AAA itself 2, 3.
- Studies have shown that first-degree relatives of patients with AAA are at a higher risk of developing the disease, with a 4.33-fold increased risk reported in one study 3.
- The risk of vascular disease in the brain, specifically, is not directly addressed in the provided studies, but the association between family history of AAA and increased risk of vascular disease suggests a possible link.
Genetic Factors and Vascular Disease
- Genetic factors are thought to play a significant role in the development of AAA, with several genetic markers identified as associated with an increased risk of the disease 4.
- The identification of these genetic factors could improve understanding of the pathogenesis of AAA and other vascular diseases, and may be useful in identifying individuals at risk.
- However, the exact relationship between genetic factors and the risk of vascular disease in the brain is not clear from the provided studies.
Risk Factors for Vascular Disease
- Several risk factors have been identified as increasing the risk of vascular disease, including older age, smoking, hypertension, dyslipidemia, and family history of AAA 5, 6.
- These risk factors may also contribute to the risk of vascular disease in the brain, although the specific relationship between these factors and brain vascular disease is not addressed in the provided studies.
- Further research is needed to fully understand the relationship between family history of AAA and the risk of vascular disease in the brain.