Key result
Smoking and lipids show stronger links to AAA than CHD, while diabetes predicts only CHD.
Why the study?
Although abdominal aortic aneurysm and coronary heart disease are both related to atherosclerosis, there could be important differences in their risk factors.
Do cardiovascular risk factors have different associations with the incidence of abdominal aortic aneurysm compared to coronary heart disease?
Cohort (n=26,688)
Do cardiovascular risk factors have different associations with the incidence of abdominal aortic aneurysm compared to coronary heart disease?
This large cohort study demonstrates that while AAA and CHD share many atherosclerotic risk factors, their distinct risk profiles suggest potentially different underlying pathophysiological mechanisms.
Answers are grounded in this paper and cite their sources.
Differential risk factor associations for AAA versus CHD support distinct mechanisms; hypothesis-generating but should not yet change practice.
Even though abdominal aortic aneurysm (AAA) and coronary heart disease (CHD) are both related to atherosclerosis, there could be important differences in risk factors. Based on Malmö Diet and Cancer Cohort, the incidence of AAA and CHD was followed prospectively. Cox regression was used to calculate the association of each factor with AAA and CHD and hazards ratio were compared using a modified Lunn-McNeil method; 447 participants developed AAA and 3129 developed CHD. After multivariate adjustments, smoking, antihypertensive medications, lipid-lowing medications, systolic and diastolic blood pressures, apolipoprotein (Apo) A1 (inversely), ApoB, ApoB/ApoA1 ratio, total leukocyte count, neutrophil count, and neutrophil to lymphocyte ratio were associated with the risks of both AAA and CHD. When comparing risk factor profiles for the 2 diseases, smoking, diastolic blood pressure, ApoA1, and ApoB/ApoA1 ratio had stronger associations with risk of AAA than with risk of CHD, while diabetes and unmarried status showed increased risk of CHD, but not of AAA (all P values for equal association <.01). The results from this big population study confirm that the risk factor profiles for AAA and CHD show not only many similarities but also several important differences.
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Xiao et al. (2020) conducted a cohort in Abdominal Aortic Aneurysm (AAA) and Coronary Heart Disease (CHD) (n=26,688). Cardiovascular risk factors (e.g., smoking, blood pressure, lipids, diabetes) vs. Participants without the respective risk factors was evaluated on Incidence of AAA and CHD (p=<.01). Smoking, diastolic blood pressure, and ApoB/ApoA1 ratio had stronger associations with incident AAA than CHD, whereas diabetes increased CHD risk but not AAA risk (P<0.01 for equal associations).
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