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3. MEDICAL AND HEALTH SCIENCES, 3.2 CLINICAL MEDICINE, Cardiac and Cardiovascular systems
Introduction: Abdominal Aortic Aneurysm (AAA) screening programmes have been carried out worldwide on males between the ages of 65-75 years. The results of such programmes show AAA screening to be beneficial and cost effective. In the Multicentre Aneurysm Screening Study conducted in the United Kingdom, the incidence of AAA was 4.9%. Early diagnoses of AAA’s have reduced AAA related deaths by 42%. This study investigated the incidence of AAA in Irish males between the ages of 55-75 years and incorporated an assessment of cardiovascular risk factors. A younger group of males were screened to see if there was any benefit in screening for AAA and to determine the incidence of cardiovascular risk factors in this younger population. Method: From April 2006 to December 2007, males ages between 55-75 years living in the catchment area of the hospital, were invited to participate in the screening programme. A ultrasound scan of their aortas was preformed and a finger prick blood test was carried out to assess their cardiovascular risk factor status. Results: Nine hundred and four participants were screened. Of these, 17 (1.9%) participants had an undiagnosed AAA, of which 4.2% were aged between 65-75years and 0.6% aged between 55-64 years. The incidence for hypertension, 33% had been previously diagnosed with hypertension, with 165 of these uncontrolled. In the participants with no history of HTN, 31% had an elevated blood pressure reading. The study found, 26% had a previous history of hypercholesterolemia, with 70% of these remaining uncontrolled. Of those with no previous history of hypercholesterolemia, 33% had an elevated reading. The glucose results revealed 3% of the total participants had a raised glucose level with had no previous history of DM. Of those who were being treated for diabetes, 49% showed poor sugar control. Only 63% (573) of all participants agreed to have their body mass index measured. Of these, 16% were found to be morbidly obese and 64% were overweight. Conclusion: The incidence of AAA in males between 65-75 years is similar to other worldwide studies, therefore screening would be beneficial in Ireland. However, screening males of 55-65 years was not proven to be beneficial. Cardiovascular risk factors, such as hypertension, hypercholesterolemia and diabetes are very prevalent in Ireland. In this study 8 the prevalence of cardiovascular risk factors were high. Of those who have been diagnosed with a cardiovascular risk factor, many remain uncontrolled despite treatment. There was also a larger number of the screened population undiagnosed for their risk factors. Therefore screening for cardiovascular risk factors is a necessity and it can easily be incorporated in to other screening programmes.
Brosnan, M.: Is there a Benefit to Screening for Abdominal Aortic Aneurysm in the Irish Male Population between the ages of 55 to 75 years; an Ideal Opportunity Group for Evaluating Cardiovascular Risk Factors? Masters Thesis. Dublin Institute of Technology, 2011.