Atherosclerosis in abdominal aortic aneurysms: a causal event or a process running in parallel? The Tromsø study

Arterioscler Thromb Vasc Biol. 2010 Jun;30(6):1263-8. doi: 10.1161/ATVBAHA.110.203588. Epub 2010 Apr 1.


Objective: The pathogenesis of abdominal aortic aneurysm (AAA) formation is poorly understood. We investigated the relationship between carotid, femoral, and coronary atherosclerosis and abdominal aortic diameter, and whether atherosclerosis was a risk marker for AAA.

Methods and results: Ultrasound of the right carotid artery, the common femoral artery, and the abdominal aorta was performed in 6446 men and women from a general population. The burden of atherosclerosis was assessed as carotid total plaque area, common femoral lumen diameter, and self-reported coronary heart disease. An AAA was defined as maximal infrarenal aortic diameter > or =30 mm. No dose-response relationship was found between carotid atherosclerosis and abdominal aortic diameter <27 mm. However, significantly more atherosclerosis and coronary heart disease was found in aortic diameter > or =27 mm and in AAAs. The age- and sex-adjusted odds ratio (OR) (95% CI) for AAA in the top total plaque area quintile was 2.3 (1.5 to 3.4), as compared with subjects without plaques. The adjusted OR (95% CI) was 1.7 (1.1 to 2.6). No independent association was found between femoral lumen diameter and AAA.

Conclusions: The lack of a consistent dose-response relationship between atherosclerosis and abdominal aortic diameter suggests that atherosclerosis may not be a causal event in AAA but develops in parallel with or secondary to aneurismal dilatation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aortic Aneurysm, Abdominal / diagnostic imaging
  • Aortic Aneurysm, Abdominal / epidemiology*
  • Atherosclerosis / diagnostic imaging
  • Atherosclerosis / epidemiology*
  • Carotid Artery Diseases / epidemiology*
  • Comorbidity
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / epidemiology*
  • Female
  • Femoral Artery* / diagnostic imaging
  • Humans
  • Linear Models
  • Logistic Models
  • Male
  • Middle Aged
  • Norway / epidemiology
  • Odds Ratio
  • Peripheral Vascular Diseases / diagnostic imaging
  • Peripheral Vascular Diseases / epidemiology*
  • Population Surveillance
  • Prevalence
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Sex Factors
  • Ultrasonography