Persistent increase in the incidence of abdominal aortic aneurysm in Scotland, 1981–2000

BACKGROUND: In the 1970s and 1980s, mortality and morbidity rates for abdominal aortic aneurysm (AAA) increased throughout the developed world. As AAAs are associated with similar risk factors to other cardiovascular diseases that have recently decreased in incidence, the incidence of AAA should show a similar declining trend. METHODS: Routinely collected data were obtained on all primary diagnoses of aortic aneurysm resulting in death or hospital discharge in Scotland between 1981 and 2000. Trends in the data were analysed according to sex and age, aneurysm site and type of hospital admission. RESULTS: Between 1981 and 2000, 42.3 per cent of the 10 822 deaths from aortic aneurysm in Scotland were attributed to the abdominal aorta. Age-adjusted mortality rates for AAA increased 2.6-fold from 2.62 deaths per 100 000 in 1981 to 6.82 per 100 000 in 2000. Hospital admissions for AAA also rose threefold, with increases in both elective admissions (from 3.05 to 7.80 per 100 000) and emergency admissions (from 7.44 to 11.23 per 100 000). CONCLUSION: The incidence of AAA has increased over the past 20 years in Scotland. This is unlikely to be due simply to changes in detection and diagnosis, data inaccuracies, coding or ageing of the population. The incidence of both elective and emergency admission for AAA increased, suggesting that a genuine and persistent rise in the incidence of AAA has probably occurred.