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Cardiovascular system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Ultrasound is also the technique of choice for abdominal aortic aneurysm screening (see page 490) [93] as it is sensitive in suitable patients and carries no radiation risk; it is unusual to be unable to obtain a sufficiently good image to measure the diameter of the aorta (see pages 492–3).
Ruptured Abdominal Aortic Aneurysms
Published in Stephen M. Cohn, Peter Rhee, 50 Landmark Papers, 2019
Abdul Q. Alarhayem, Mark G. Davies
Abdominal aortic aneurysms (AAA) affect 7%–9% of the population over the age of 65 years, with a higher prevalence in smokers. The natural course of an unrepaired AAA is continued growth, and ultimately rupture and death. Aneurysm diameter, expansion rate, female gender, low FEV1, current smoking, and hypertension have all been associated with an increased risk of rupture.
Management of peripheral arterial disease in the elderly
Published in Wilbert S. Aronow, Jerome L. Fleg, Michael W. Rich, Tresch and Aronow’s Cardiovascular Disease in the Elderly, 2019
The prevalence of abdominal aortic aneurysm (AAA) increases with advancing age, smoking, hypercholesterolemia, hypertension, male gender, and family history (7,8,172–174). The prevalence of an AAA varies from 1.3% for men aged 45–54 years to 12.5% for men aged 75–84 years (7,8). The prevalence of an AAA varies from 0% for women aged 45–54 years to 5.2% for women aged 75–84 years (7,8). Most patients with an AAA are asymptomatic, with their AAA noted on studies performed for other reasons rather than on physical examination. Of 110 men with an AAA, 71% had CAD, 46% had lower extremity PAD, and 27% had cerebrovascular disease (175). The prognosis of an AAA in women is worse than in men (176).
Characterising recovery following abdominal aortic aneurysm repair using cardiopulmonary exercise testing and patient reported outcome measures
Published in Disability and Rehabilitation, 2023
N. Dodds, J. Angell, S. L. Lewis, M. Pyke, P. White, A. Darweish-Medniuk, D. C. Mitchell, S. Tolchard
Forty-two patients undergoing abdominal aortic aneurysm (AAA) repair, by open (n = 21) or endovascular (EVAR; n = 21) approach, were recruited in the vascular outpatient’s clinic or during pre-operative assessment between 2010 and 2015. Informed consent was obtained by a consultant or clinical research fellow trained in Good Medical Practice. All patients received consultant-delivered surgical and anaesthetic care. The study received local ethical approval from our local Health Research Authority, Bristol NRES Southwest, with restrictions that limited the study design such that it was not possible to recruit consecutive patients. Patients over the age of 18 years were considered for the study, with the following exclusions; Patients that suffered post-operative complications or were considered inoperable, those patients unable or unwilling to perform an ergometer test or participate in the study, and patients from outside the Bristol area for whom participation would represent a significant burden. The approval also stipulated that patients not be re-tested within 4 weeks of surgery. The study incorporated patient safety pathways to identify patients with potentially reversible cardiac or pulmonary morbidity; in such cases, the surgeon was informed and the patient referred to the appropriate specialty. None of the patients in the study were involved in any prehabilitation or cardiac rehabilitation programs.
Developing and evaluating a prototype public health mobile app on the UK NHS Abdominal Aortic Aneurysm Screening Programme
Published in Journal of Visual Communication in Medicine, 2022
Ella Jones, Matthieu Poyade, Ourania Varsou
An aneurysm is defined as a dilation of an artery by at least a 50% widening above its normal diameter (Johnston et al., 1991). Abdominal Aortic Aneurysms (AAA) are often asymptomatic (the patient shows no symptoms until diagnosed by a healthcare professional); a meta-analysis identified that 4.8% of the general population has an asymptomatic AAA (Li, Zhao, Zhang, Duan, & Xin, 2013). Abdominal Aortic Aneurysms occur in 1.3–5% of the male population aged 65–74 in the UK (Wanhainen, 2019). Mortality from spontaneous AAA rupture is significant at 85% (Scott, Bridgewater, & Ashton, 2002). Advanced age is a major risk factor with men being six times more likely to have AAA compared to women. Age 65 is the standard for starting screening considering the prevalence of AAA vs. the risk of rupture (Scott, 2002).
Age and diabetes control in an HIV-endemic country: is there an association?
Published in Journal of Endocrinology, Metabolism and Diabetes of South Africa, 2022
It is well established that there is an association between hypertension and cardiovascular disease (CVD), commonly resulting in increased mortality.26 PLWD have a 200–400% risk of dying from CVD,27 while some estimate that it can be as high as 10 times the risk of the general population.28 In patients with hypertension and DM, the CVD risk increases by a further 75%.29 In our study, systolic hypertension was positively associated with age. This is similar to what has been shown in other studies globally. An American study conducted by Ostchega et al. highlighted the increased prevalence of hypertension with age.30 In contrast to this, our study found that the mean age of patients with increased DBP ≥ 90 mmHg was younger than those with a DBP < 90 mmHg. According to Li et al., DBP is an important risk factor for coronary disease in younger patients.31 It has also been shown to be a risk factor for formation of an abdominal aortic aneurysm.32 Clinicians should be aware of this risk factor and pay special attention to diastolic blood pressures just as much in the younger PLWD as they do for older patients. In SA, Steyn et al. highlighted that the care of patients with DM and hypertension is suboptimal.33 Strained healthcare systems are a major challenge, especially in Africa, with only 2% of patients having good control of hypertension.34 It is therefore important to implement effective early interventions to manage non-communicable diseases such as DM and HPT, especially when they coexist.