Prevalence of Abdominal Aortic Aneurysm in the Philippines
There is no published data specifically reporting the prevalence of abdominal aortic aneurysm (AAA) in the Philippines. However, based on available evidence from Asian populations, the prevalence is likely to be substantially lower than in Western populations but may approach Western rates in high-risk subgroups.
Expected Prevalence Based on Asian Population Data
The overall AAA prevalence in general Asian populations is approximately 1.30% (95% CI, 1.01%-1.59%), which is significantly lower than the 4-8% prevalence reported in Western populations 1. This represents a roughly 3-6 fold lower baseline risk compared to Caucasian populations.
Risk-Stratified Prevalence Estimates
In Asian populations selected for cardiovascular risk factors, the AAA prevalence increases to 2.56% (95% CI, 1.81%-3.31%), approaching Western population rates 1.
In Asian populations without cardiovascular risk factor selection, the prevalence drops to just 0.61% (95% CI, 0.37%-0.85%) 1.
Among Asian men aged ≥70 years, the incidence rate can reach 78.3 per 100,000, while women aged ≥70 years show rates of 18.7 per 100,000 2.
Key Demographic Patterns Applicable to the Philippines
Men demonstrate a 3.5:1 male-to-female ratio for AAA diagnosis in Asian populations 2, which is consistent with the general pattern where men aged ≥65 years have 5-13 fold higher baseline risk than women 3.
Age-Related Prevalence
The median age at AAA diagnosis in Asian populations is 70 years, with a range of 39-88 years 2.
In men aged 65-75 years who have ever smoked, Western populations show prevalence rates of 9.1-22%, but this would be expected to be lower in Filipino populations based on Asian data 4.
Women aged ≥65 years in Western populations show AAA prevalence of 2-6.2%, with Asian women expected to have approximately one-sixth the prevalence of men 4.
Risk Factors Relevant to Filipino Populations
The major risk factors that would drive AAA prevalence in the Philippines include male sex, smoking history (≥100 cigarettes lifetime), age ≥65 years, hypertension, hypercholesterolemia, and family history of AAA or cardiovascular disease 4.
Smoking, hypertension, or respiratory disorders are present in more than 40% of Asian patients diagnosed with AAA 2.
Asian race appears to have a protective association with AAA in men but not in women, though this finding requires further validation 5.
Diabetes mellitus is associated with decreased AAA risk across populations 4.
Clinical Implications for the Philippines
Given the lower baseline prevalence in Asian populations, population-wide screening programs as implemented in Western countries may not be cost-effective in the Philippines 1. However, targeted screening in Filipino men aged 65-75 years with cardiovascular risk factors—particularly current or former smokers with hypertension or hypercholesterolemia—could potentially yield benefits approaching those seen in Western screening programs 1.
Opportunistic Detection Strategy
Opportunistic screening during abdominal ultrasound examinations performed for other indications or during transthoracic echocardiography should be considered, as this approach may be more appropriate for populations with lower baseline prevalence 1.
Important Caveats
The absence of Philippines-specific data represents a significant knowledge gap that limits precise prevalence estimates for this population.
Incidental AAA detection on CT scans performed for other reasons shows prevalence rates of 2.2-5.8% even in mixed populations, suggesting that opportunistic detection may identify clinically relevant cases 4.
The catastrophic nature of AAA rupture, with 75-90% mortality and over half of deaths occurring before hospital arrival, justifies heightened clinical awareness even in populations with lower baseline prevalence 3, 6.