ANEURYSM SCREENING BREAKTHROUGH
Medical research reveals an alarming prevalence ticking time bomb in 50+
They are often described as “ticking time bombs” and can rob us of family members without warning. It has been widely thought that men are more at risk of an aneurysm than women, however new research may debunk that.
University of Otago vascular researchers have developed a process that could revolutionise aneurysm detection and management – potentially saving lives.
An aneurysm is a blood-filled bulge in a weakened blood vessel wall and is commonly found in the abdominal aorta. If the bulge grows enough to suddenly rupture, eight out of ten of those affected will not survive. However, when detected early, aneurysms can be repaired and rupture prevented.
A University of Otago team, led by Professor Greg Jones, has been investigating how to best identify those with the greatest risk of developing aortic aneurysm. “Abdominal aortic aneurysm (AAA) continues to be a significant health burden yet few countries have implemented a comprehensive screening programme,” Jones says. “Screening typically places emphasis on men aged over 65 years; however, there is concern that other at-risk groups may be underidentified.”
Jones’ team looked at the widely used 30mm measurement used to define an aneurysm - based on the average size of blood vessels in men. This does not account for differences in body size, particularly in women. When blood vessel measurement is adjusted to reflect body size, his team showed men and women have a similar risk.
The prevalence of aneurysm was determined by abdominal ultrasound imaging in over 50-year-olds undergoing coronary angiography, vascular laboratory assessment of peripheral arterial disease, or community-based cardiovascular disease (CVD) event risk assessment. A fourth group, consisting of volunteers aged over 60 years with no signs of cardiovascular disease, was used as a comparator group.
This work was co-funded by Otago Medical Research Foundation.
“The study clearly showed we are underestimating the true prevalence: women and smaller men have more chance of having an aortic aneurysm than health professionals previously realised,” Jones says. “This is a particular problem in New Zealand, with a high prevalence of Ma ori women who smoke and are, therefore, at higher risk. Using this false assumption has likely contributed to a health inequality.”
The researchers are working with a national consortium of vascular surgeons on a pilot study to test a screening programme taking body size into account. It has the potential to globally revolutionise the identification and management of this condition.
“It’s a game changer that will save lives, but the discovery is controversial,” Jones explains. “Global screening programmes are based on a belief that aortic aneurysms are a disease primarily of men. This assumption will have to change.”