Why the study?
Does ultrasound screening effectively detect abdominal aortic aneurysms in elderly hypertensive male patients with or without cardiovascular complications?
Does ultrasound screening effectively detect abdominal aortic aneurysms in elderly hypertensive male patients with or without cardiovascular complications?
Ultrasound screening for AAA is high-yield in elderly hypertensive men with claudication, but not indicated for those with uncomplicated hypertension alone.
Claudication may identify higher-yield subgroups for AAA screening in hypertensive men; leaves open need for outcome trials before practice change.
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.
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A 1996 study studied this question.
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