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      Primary results of abdominal aortic aneurysm screening in the at-risk residents in middle China

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          Abstract

          Background

          There is a lack of information on the epidemiological data and risk factors associated with abdominal aortic aneurysm (AAA) in Chinese population. We reported the primary results from screening five-community population in Middle China for AAA.

          Methods

          From March 2014 to October 2015, an AAA screening program was performed in three urban and two rural communities. These communities were randomly selected. All at-risk residents (a total of 6925) aged 40 years or older were invited to attend an ultrasound scan for AAA. At-risk population was defined as having a family history of first-degree relative diagnosed with AAA; or smoking and aged 55 years or older; or having a history of CAD, cerebrovascular disease, hypercholesterolemia, obesity (BMI ≧ 26 kg/m 2) or hypertension.

          Results

          The study investigated 5402 subjects and the mean age of them was 61.2 ± 10.4 years old. It included 2847 women aged 62.5 ± 10.4 years and 2555 men aged 59.7 ± 10.2 years. The mean maximum infrarenal aortic diameter (Max-IAD) was 15.0 ± 2.7 mm (from 4.1 to 51.5 mm). Eighteen people (aged 68.0 ± 10.4 years) with AAAs were detected (prevalence rate was 0.33%), and the prevalence rate in males was higher than in females (0.55% vs 0.14%, respectively, P = 0.009). Additionally, the screened subjects aged 55 to 75 years had a higher prevalence rate of AAA than other age groups (0.51% vs 0.11%, respectively, P = 0.016).

          Conclusion

          The mean Max-IAD of the screened population in Middle China was apparently small by comparison with other reports. The result of low prevalence rate of AAA didn’t support routine screening in Chinese population. The at-risk males aged 55 to 75 years should be targeted for further screening.

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          Most cited references23

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          Management of abdominal aortic aneurysms clinical practice guidelines of the European society for vascular surgery.

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            Analysis of risk factors for abdominal aortic aneurysm in a cohort of more than 3 million individuals.

            Abdominal aortic aneurysm (AAA) disease is an insidious condition with an 85% chance of death after rupture. Ultrasound screening can reduce mortality, but its use is advocated only for a limited subset of the population at risk. We used data from a retrospective cohort of 3.1 million patients who completed a medical and lifestyle questionnaire and were evaluated by ultrasound imaging for the presence of AAA by Life Line Screening in 2003 to 2008. Risk factors associated with AAA were identified using multivariable logistic regression analysis. We observed a positive association with increasing years of smoking and cigarettes smoked and a negative association with smoking cessation. Excess weight was associated with increased risk, whereas exercise and consumption of nuts, vegetables, and fruits were associated with reduced risk. Blacks, Hispanics, and Asians had lower risk of AAA than whites and Native Americans. Well-known risk factors were reaffirmed, including male gender, age, family history, and cardiovascular disease. A predictive scoring system was created that identifies aneurysms more efficiently than current criteria and includes women, nonsmokers, and individuals aged <65 years. Using this model on national statistics of risk factors prevalence, we estimated 1.1 million AAAs in the United States, of which 569,000 are among women, nonsmokers, and individuals aged <65 years. Smoking cessation and a healthy lifestyle are associated with lower risk of AAA. We estimated that about half of the patients with AAA disease are not eligible for screening under current guidelines. We have created a high-yield screening algorithm that expands the target population for screening by including at-risk individuals not identified with existing screening criteria.
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              Deaths: final data for 2005.

              This report presents final 2005 data on U.S. deaths, death rates, life expectancy, infant and maternal mortality, and trends by selected characteristics such as age, sex, Hispanic origin, race, marital status, educational attainment, injury at work, state of residence, and cause of death. This report presents descriptive tabulations of information reported on death certificates, which are completed by funeral directors, attending physicians, medical examiners, and coroners. The original records are filed in the state registration offices. Statistical information is compiled into a national database through the Vital Statistics Cooperative Program of the Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS). Causes of death are processed in accordance with the International Classification of Diseases, Tenth Revision (ICD-10). In 2005, a total of 2,448,017 deaths were reported in the United States. The age-adjusted death rate was 798.8 deaths per 100,000 standard population, representing a decrease of 0.2 percent from the 2004 rate and a record low historical figure. Life expectancy at birth remained the same as that in 2004-77.8 years. Age-specific death rates decreased for the age group 65-74 years but increased for the age groups 15-24 years, 25-34 years, and 45-54 years. The 15 leading causes of death in 2005 remained the same as in 2004. Heart disease and cancer continued to be the leading and second leading causes of death, together accounting for almost one-half of all deaths. The infant mortality rate in 2005 was 6.87 deaths per 1,000 live births. Generally, mortality patterns in 2005, such as the age-adjusted death rate declining to a record historical low, were consistent with long-term trends. Life expectancy in 2005 remained the same as that in 2004.
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                Author and article information

                Contributors
                li_kun_12@163.com
                zhang_kewei12@163.com
                li_tianxiao@163.com
                +86-0371-65580014 , Zhaishuiting2008@163.com
                Journal
                BMC Cardiovasc Disord
                BMC Cardiovasc Disord
                BMC Cardiovascular Disorders
                BioMed Central (London )
                1471-2261
                3 April 2018
                3 April 2018
                2018
                : 18
                : 60
                Affiliations
                GRID grid.414011.1, Department of Vascular and Endovascular Surgery, , Henan Provincial People’s Hospital, Fuwai Central China Cardiovascular Hospital, ; NO.7 Weiwu Road, Zhengzhou, 450003 Henan People’s Republic of China
                Author information
                http://orcid.org/0000-0002-5723-1438
                Article
                793
                10.1186/s12872-018-0793-5
                5883536
                29614976
                cc032798-0d1a-4d3c-8e7c-9ab3ec2c39c4
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 28 April 2017
                : 20 March 2018
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100001809, National Natural Science Foundation of China;
                Award ID: 81301328
                Funded by: Henan provincial Medical Science and technology research program
                Award ID: 201301011
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2018

                Cardiovascular Medicine
                aaa,max-iad,prevalence rate,ultrasound screening
                Cardiovascular Medicine
                aaa, max-iad, prevalence rate, ultrasound screening

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