Screening for abdominal aortic aneurysms in a hypertensive patient population.
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, (chi)2 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 by itself is not an indication for screening.
Simon
G
G
Department of Medicine, Veterans Affairs Medical Center, Minneapolis, Minn., USA.
Nordgren
D
D
Connelly
S
S
Shultz
P J
PJ
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014463:Ultrasonography