Making the case for cardiovascular screening in Irish males: detection of abdominal aortic aneurysms, and assessment of cardiovascular risk factors.
BACKGROUND
AAA screening programmes have proven to be beneficial and cost effective worldwide for males greater than 65 years of age, with 4.9% males of 65-75 years of age having an un-diagnosed AAA at screening, resulting in a 42% reduction in the risk of rupture in an English population. This study assessed the incidence of AAA and risk factors for atherosclerosis in Irish males of 55-75 years.


METHODS
From April 2006 to December 2007, males between the ages of 55 and 75 years, living within the catchment area of Blanchardstown Hospital were invited for AAA screening using duplex ultrasound and cardiovascular risk factor screening.


RESULTS
1.9% (17/904) of the study population had previously un-diagnosed aneurysms detected, with sizes ranging from 3.0 cm to 5.8 cm (0.6% in 55-65 years old (yo) and 4.2% in 65-75 yo, p<0.01). 33% (302/904) of patients had hyperlipidaemia, while 16% of those with a previous diagnosis of hyperlipidaemia, were inadequately controlled on the test date. 31% of patients had a single elevated blood pressure reading, meriting further investigation for possible hypertension. 3% (28/904) of all patients had a raised glucose levels which had not previously been identified and of those who had a previous history of DM, 46% had abnormal glucose levels. 16% of patients (93/573) were morbidly obese (BMI>30) and 64% (292/573) were overweight.


CONCLUSIONS
The incidence of AAAs in 65-75-year-old men is similar to international figures. This study confirms that screening for hyperlipidaemia, hypercholesterolaemia, obesity and hypertension may be worthwhile in all males over 55 years, while AAA screening should be reserved for 65-75-year-old Irish males.
Brosnan
M
M
Department of Vascular Diagnostic Unit, Connolly Hospital, Blanchardstown, Dublin 15, Ireland.
Collins
C G
CG
Moneley
D S
DS
Kelly
C J
CJ
Leahy
A L
AL
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis* / Q000453:epidemiology*; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D002391:Catchment Area, Health; D003920:Diabetes Mellitus / Q000453:epidemiology; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D015994:Incidence; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D050177:Overweight / Q000453:epidemiology; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D018616:Ultrasonography, Doppler, Duplex
D001786:Blood Glucose