October 14, 1996

Screening for Abdominal Aortic Aneurysms in a Hypertensive Patient Population

Author Affiliations

From the Department of Medicine, Veterans Affairs Medical Center, Minneapolis, Minn.

Arch Intern Med. 1996;156(18):2081-2084. doi:10.1001/archinte.1996.00440170089010

Background:  Abdominal aortic aneurysm (AAA) is an important cause of preventable death in the elderly.

Objective:  To search for an effective screening program for the detection of AAA.

Methods:  We consecutively and prospectively screened 240 male, predominantly white, patients, aged 60 to 75 years, by ultrasound for the presence of AAA in 2 phases: in screen 1, hypertension (diastolic blood pressure reading >95 mm Hg) was the only selection criterion; in screen 2, we included hypertensive patients with a systolic blood pressure level higher than 175 mm Hg with or without antihypertensive therapy, transient ischemic attacks and/or stroke, and claudication.

Results:  The yield of AAAs in screens 1 and 2 was 3% and 11%, respectively (P<.02, χ2 analysis). No AAAs were found in patients with uncomplicated hypertension. Of the cardiovascular complications, only claudication was independently associated with the presence of AAA (relative risk, 5.8; confidence interval, 1.8-18.6; P=.004).

Conclusions:  Screening for AAA is recommended for elderly white patients with claudication. Uncomplicated hypertension byArch Intern Med. 1996;156:2081-2084