April 1, 1991British journal of surgery179 citations
Ver artículo completoPredictors of death from aortic aneurysm among middle-aged men: The Whitehall study
PICO estructurado
What are the predictors of death from aortic aneurysm among middle-aged men?
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Población
18,403 male civil servants examined at age 40-64 years (Whitehall study), including 99 cases of fatal aortic aneurysm matched by age to 10 controls each
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Intervención
Risk factors including smoking (manufactured cigarettes, pipe/cigars, hand-rolled cigarettes) and diastolic blood pressure
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Comparador
Lifelong non-smokers; lower diastolic blood pressure
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Resultado
Death attributed to aortic aneurysmhard clinical
Hypertension and smoking, particularly of hand-rolled cigarettes, are major and potentially remediable risk factors for fatal aortic aneurysm in middle-aged men.
Resumen
Among 18,403 male civil servants examined at age 40-64 years there were 99 deaths attributed to aortic aneurysm during 18 years of follow-up. Each case was matched by age to ten controls who survived longer than the case. The risk of all types of fatal aneurysm was substantially increased for current smokers of manufactured cigarettes (rate ratio compared with lifelong non-smokers = 6.5; 95 per cent confidence interval 2.3-18.7), pipe or cigars (6.7; 1.7-26.5) and hand-rolled cigarettes (25.0; 7.5-83.3). Diastolic blood pressure was strongly associated with dissecting aneurysm (rate ratio per 10 mmHg increase = 2.4; 95 per cent confidence interval 1.7-3.2) and abdominal aneurysm (1.5; 1.2-1.9) but not other aneurysms (1.0; 0.7-1.5). The independent effects of height, adiposity, plasma cholesterol, glucose intolerance, reported angina and intermittent claudication were not significant. Hypertension and smoking, particularly of hand-rolled cigarettes, are confirmed as major and potentially remediable risk factors for fatal aortic aneurysm.