From the Guidelines
The most common risk factor for the development of an abdominal aortic aneurysm (AAA) is older age, specifically being 65 years or older, as it is an independent and strong risk factor for AAA development. According to the 2022 ACC/AHA guideline for the diagnosis and management of aortic disease 1, older age is a significant risk factor, with the majority of AAA-related deaths occurring in men older than 65 years. The guideline also states that screening for AAA is recommended in men who are 65 years or older and have ever smoked.
Other risk factors for AAA development include male sex, smoking, and a family history of AAA. However, older age is the most significant risk factor, with the risk of AAA increasing exponentially with age. The 2022 ACC/AHA guideline also notes that having a first-degree relative with AAA is a well-established risk factor for development of AAA, but older age remains the most common risk factor.
It's worth noting that while hypertension is a risk factor for many cardiovascular diseases, it is not the most common risk factor for AAA development. According to the evidence, older age, male sex, and smoking are the strongest risk factors for AAA development 1.
In terms of specific data, a study found that the lifetime risk for AAA is 8.2% in men and 10.5% in current smokers 1. Another study found that the prevalence of AAA in men 65 years or older is significantly higher than in women of the same age group 1.
Overall, older age is the most common risk factor for AAA development, and screening for AAA is recommended in men who are 65 years or older and have ever smoked.
From the Research
Risk Factors for Abdominal Aortic Aneurysm (AAA)
The most common risk factors for the development of AAA include:
- Older age: The risk of AAA increases with age, particularly after the age of 65 years 2, 3
- Smoking: Smoking is a significant risk factor for AAA, contributing to about 50% of population risk for rupture or surgically treated AAA 4, 3, 5
- Hypertension: High blood pressure is also a risk factor for AAA, increasing the risk by 30-40% 2
- Male sex: Men are nearly six times more likely to develop an AAA than women 2
Comparison of Risk Factors
While diabetes mellitus and female sex are not directly mentioned as significant risk factors in the provided studies, hypertension and older age are identified as important factors. However, the most significant risk factor among the options provided is: