Tętniak aorty brzusznej – Etiologia i przyczyny

Tętniak aorty brzusznej
Etiologia i przyczyny

Tętniak aorty brzusznej (AAA) definiowany jest jako poszerzenie aorty brzusznej ≥3,0 cm lub >50% w stosunku do prawidłowego odcinka proksymalnego, powstający na skutek osłabienia ściany naczynia. Miażdżyca stanowi główną etiologię AAA, prowadząc do uszkodzenia ściany aorty poprzez odkładanie blaszek miażdżycowych, przewlekły stan zapalny oraz degradację białek strukturalnych. Czynniki ryzyka obejmują niemodyfikowalne: wiek >65 lat, płeć męską (4-5-krotnie wyższe ryzyko), rasę (rzadsze u Afroamerykanów, Azjatów), oraz genetyczne predyspozycje, w tym rodzinne występowanie (ryzyko 8-krotnie wyższe przy chorobie u rodzeństwa) i zespoły tkanki łącznej (Marfan, Ehlers-Danlos, Loeys-Dietz). Modyfikowalne czynniki ryzyka to przede wszystkim palenie tytoniu (7-krotnie zwiększone ryzyko), nadciśnienie tętnicze oraz hipercholesterolemia. Dodatkowo, choroby współistniejące jak POChP, choroba wieńcowa i miażdżyca obwodowa zwiększają ryzyko AAA, podczas gdy cukrzyca wykazuje negatywną korelację z rozwojem tętniaka.

Etiologia tętniaka aorty brzusznej

Miażdżyca jako główna przyczyna
Czynniki ryzyka demograficzne
Czynniki genetyczne i rodzinne
Styl życia i czynniki modyfikowalne
Choroby współistniejące
Procesy patologiczne w ścianie aorty
Rzadsze przyczyny i czynniki predysponujące
Farmakologiczne czynniki ryzyka

Mechanizmy powstawania AAA

Zmiany strukturalne w ścianie aorty
Rola procesów zapalnych

Podsumowanie czynników ryzyka

Kolejne rozdziały

Etiologia tętniaka aorty brzusznej

Tętniak aorty brzusznej (AAA – Abdominal Aortic Aneurysm) definiowany jest jako poszerzenie aorty brzusznej o średnicy 3,0 cm lub większej, bądź jako poszerzenie aorty o ponad 50% w stosunku do prawidłowego odcinka proksymalnego. Rozwija się on na skutek osłabienia ściany aorty, co prowadzi do jej stopniowego rozszerzania i uwypuklania. Dokładna przyczyna tego procesu nie jest w pełni poznana, jednak zidentyfikowano szereg czynników, które przyczyniają się do powstania tętniaka aorty brzusznej.¹²

Miażdżyca jako główna przyczyna

Miażdżyca (atherosclerosis) jest uważana za najczęstszą przyczynę tętniaków aorty brzusznej. Proces miażdżycowy charakteryzuje się odkładaniem się złogów tłuszczowych, cholesterolu i innych substancji w ścianie naczynia, tworząc blaszki miażdżycowe. Te złogi powodują uszkodzenie i osłabienie ściany aorty, co prowadzi do jej rozszerzenia i tworzenia tętniaka.³⁴

Miażdżyca może przyczyniać się do rozwoju AAA poprzez:⁵

Uszkodzenie wewnętrznej warstwy ściany aorty
Wywołanie przewlekłego stanu zapalnego
Powodowanie degradacji białek strukturalnych w ścianie aorty
Poszerzanie aorty w próbie utrzymania przepływu krwi, co prowadzi do dalszego osłabienia jej ściany

⁶⁷

Czynniki ryzyka demograficzne

Istnieje kilka niemodyfikowalnych czynników demograficznych, które znacząco zwiększają ryzyko rozwoju tętniaka aorty brzusznej:⁸

Wiek – ryzyko AAA rośnie wraz z wiekiem. Tętniaki aorty brzusznej występują najczęściej u osób powyżej 65 roku życia. Z wiekiem ściany aorty naturalnie tracą elastyczność i stają się sztywniejsze, co zwiększa podatność na tworzenie się tętniaków.
Płeć męska – mężczyźni chorują 4-5 razy częściej niż kobiety. Jednakże u kobiet istniejący tętniak może pęknąć przy mniejszej średnicy niż u mężczyzn.
Rasa/pochodzenie etniczne – tętniaki aorty brzusznej występują rzadziej u osób pochodzenia hiszpańskiego, Afroamerykanów i Azjatów.

⁹¹⁰¹¹

Czynniki genetyczne i rodzinne

Predyspozycje genetyczne odgrywają istotną rolę w rozwoju tętniaków aorty brzusznej:¹²

Występowanie rodzinne – około 10-20% osób z AAA ma krewnego pierwszego stopnia (rodzic, rodzeństwo, dziecko) z tym samym schorzeniem. Ryzyko rozwoju AAA jest około 8 razy większe dla osób, których rodzeństwo cierpi na to schorzenie.
Genetyczne zaburzenia tkanki łącznej – takie jak zespół Marfana, zespół Ehlersa-Danlosa, zespół Loeysa-Dietza i inne mogą predysponować do rozwoju AAA poprzez osłabienie struktury ściany aorty.
Wrodzone wady sercowo-naczyniowe – jak dwupłatkowa zastawka aortalna czy koarktacja aorty zwiększają ryzyko wystąpienia AAA.

¹³¹⁴

Badania sugerują, że genetyczna predyspozycja do AAA może być związana z pojedynczym dominującym genem o niskiej penetracji, która zwiększa się z wiekiem. Naukowcy zidentyfikowali również potencjalne autoimmunologiczne podłoże rozwoju AAA związane z locus głównego układu zgodności tkankowej DRB1.¹⁵

Styl życia i czynniki modyfikowalne

Do najważniejszych modyfikowalnych czynników ryzyka rozwoju tętniaka aorty brzusznej należą:¹⁶

Palenie tytoniu – jest to najsilniejszy modyfikowalny czynnik ryzyka AAA. Osoby palące mają nawet 7 razy większe ryzyko rozwoju tętniaka aorty brzusznej niż osoby niepalące. Dym tytoniowy zawiera substancje, które uszkadzają ścianę aorty, powodując utratę białek strukturalnych i zmniejszając jej wytrzymałość. Palenie przyspiesza także wzrost istniejącego już tętniaka i zwiększa ryzyko jego pęknięcia.
Nadciśnienie tętnicze – zwiększone ciśnienie krwi wywiera dodatkowy nacisk na ściany aorty, prowadząc do ich uszkodzenia i osłabienia. Jest to główny czynnik ryzyka tętniaków aorty piersiowej, ale także istotny czynnik w przypadku tętniaków aorty brzusznej.
Hipercholesterolemia – wysokie stężenie cholesterolu przyczynia się do rozwoju miażdżycy, która jest głównym czynnikiem ryzyka AAA.

¹⁷¹⁸¹⁹

Choroby współistniejące

Niektóre choroby zwiększają ryzyko rozwoju tętniaka aorty brzusznej:²⁰

Choroba wieńcowa i miażdżyca obwodowa – osoby z miażdżycą naczyń obwodowych mają zwiększone ryzyko rozwoju AAA.
Przewlekła obturacyjna choroba płuc (POChP) – zwiększa ryzyko AAA, co może być związane z częstym współwystępowaniem z paleniem tytoniu.
Choroby zapalne naczyń krwionośnych – zapalenia naczyń, takie jak olbrzymiokomórkowe zapalenie tętnic czy choroba Takayasu, mogą powodować osłabienie ściany aorty.

²¹²²

Interesującą obserwacją jest fakt, że cukrzyca jest związana ze zmniejszonym ryzykiem rozwoju AAA. Mechanizm tej ujemnej korelacji nie jest w pełni wyjaśniony.²³²⁴

Procesy patologiczne w ścianie aorty

Na poziomie tkankowym w rozwoju tętniaka aorty brzusznej uczestniczą następujące procesy:²⁵²⁶

Degradacja macierzy pozakomórkowej – utrata integralności strukturalnej ściany aorty wynika z zaburzeń w równowadze między produkcją a degradacją białek strukturalnych.
Zaburzenia funkcji komórek mięśni gładkich – prowadzą do osłabienia ściany aorty poprzez zaburzenia w syntezie białek strukturalnych i zmiany fenotypowe tych komórek.
Stan zapalny – przewlekły stan zapalny w ścianie aorty przyczynia się do degradacji białek strukturalnych i osłabienia ściany naczynia.
Stres oksydacyjny – zwiększona produkcja wolnych rodników uszkadza składniki ściany aorty.
Neowaskularyzacja – tworzenie nowych, nieprawidłowych naczyń krwionośnych w ścianie aorty.

²⁷²⁸

Rzadsze przyczyny i czynniki predysponujące

Mniej powszechne, ale istotne przyczyny tętniaków aorty brzusznej obejmują:²⁹

Infekcje – rzadko, zakażenia bakteryjne lub grzybicze aorty mogą prowadzić do powstania tzw. tętniaków mykotycznych. Najczęstszą przyczyną tętniaków mykotycznych jest Staphylococcus aureus, a następnie Salmonella. Inne zakażenia, takie jak kiła, mogą również prowadzić do uszkodzenia aorty.
Martwica torbielowata błony środkowej (cystic medial necrosis) – degeneracja błony środkowej ściany aorty.
Urazy – poważne urazy, np. w wyniku wypadku samochodowego, mogą uszkodzić ścianę aorty i prowadzić do powstania tętniaka.
Pooperacyjne zaburzenia zespolenia – mogą prowadzić do powstania tętniaków rzekomych.

³⁰³¹³²

Farmakologiczne czynniki ryzyka

W 2018 roku FDA wydała ostrzeżenie, że stosowanie fluorochinolonów może zwiększać ryzyko wystąpienia tętniaka aorty. Zalecono unikanie przepisywania tych antybiotyków pacjentom z ryzykiem tętniaka aorty lub z już istniejącym tętniakiem, w tym osobom z miażdżycą naczyń obwodowych, nadciśnieniem tętniczym, określonymi chorobami genetycznymi (np. zespołem Marfana, zespołem Ehlersa-Danlosa) oraz osobom starszym.³³

Mechanizmy powstawania AAA

Proces formowania się tętniaka aorty brzusznej jest złożony i obejmuje szereg wzajemnie powiązanych mechanizmów:³⁴

Zmiany strukturalne w ścianie aorty

Ściana aorty jest normalnie elastyczna, co pozwala jej rozszerzać się i kurczyć w odpowiedzi na przepływ krwi. W przypadku AAA dochodzi do:³⁵

Zakłócenia struktury białek podporowych ściany aorty
Utraty włókien elastyny, która jest kluczowym białkiem nadającym elastyczność ścianie aorty
Degradacji kolagenu, który zapewnia wytrzymałość ściany naczynia
Zmniejszonej elastyczności i sztywnienia ściany aorty związanego z wiekiem

³⁶

Te zmiany strukturalne prowadzą do osłabienia ściany aorty, co w połączeniu z ciągłym naciskiem przepływającej krwi powoduje stopniowe poszerzanie się naczynia i formowanie tętniaka.³⁷

Rola procesów zapalnych

Stan zapalny odgrywa kluczową rolę w inicjacji i progresji tętniaka aorty brzusznej:³⁸

Aktywacja komórek zapalnych prowadzi do uwolnienia enzymów proteolitycznych (metaloproteinazy macierzy) rozkładających białka strukturalne ściany aorty
Cytokiny zapalne przyczyniają się do zmian w ścianie aorty i wpływają na fenotyp komórek mięśni gładkich
Procesy zapalne powodują śmierć komórek ściany aorty, osłabiając jej strukturę
Zwiększona ekspresja receptorów TLR2 (Toll-like receptor 2) i ich ligandów w tkance tętniaka przyczynia się do przewlekłego stanu zapalnego

³⁹

Wszystkie te procesy przyczyniają się do postępującego osłabienia ściany aorty, jej rozszerzania się i ostatecznie mogą prowadzić do pęknięcia tętniaka, co stanowi zagrożenie dla życia pacjenta.⁴⁰

Podsumowanie czynników ryzyka

Tętniak aorty brzusznej jest schorzeniem wieloczynnikowym, wynikającym z interakcji między predyspozycjami genetycznymi a czynnikami środowiskowymi. Do najważniejszych czynników ryzyka należą:⁴¹⁴²

Kategoria	Czynniki ryzyka	Znaczenie kliniczne
Demograficzne	– Wiek >65 lat – Płeć męska – Rasa biała	Mężczyźni >65 lat mają największe ryzyko; AAA występuje 4-5 razy częściej u mężczyzn niż u kobiet
Genetyczne	– Historia rodzinna AAA – Zespół Marfana – Zespół Ehlersa-Danlosa – Zespół Loeysa-Dietza	Ryzyko wzrasta 8-krotnie u osób z rodzeństwem z AAA; 15-25% przypadków AAA ma charakter rodzinny
Styl życia	– Palenie tytoniu – Nadużywanie alkoholu	Palenie odpowiada za około 75% wszystkich przypadków AAA; jest to najsilniejszy modyfikowalny czynnik ryzyka
Choroby współistniejące	– Nadciśnienie tętnicze – Hipercholesterolemia – Miażdżyca naczyń – Choroba wieńcowa – POChP – Choroba tętnic obwodowych	Miażdżyca jest najczęstszą przyczyną AAA; nadciśnienie tętnicze zwiększa nacisk na ścianę aorty
Rzadsze przyczyny	– Infekcje aorty – Urazy – Zapalenie naczyń – Martwica torbielowata błony środkowej	Infekcje (kiła, S. aureus, Salmonella) mogą prowadzić do tzw. tętniaków mykotycznych; urazy mogą bezpośrednio uszkodzić ścianę aorty

Warto zauważyć, że czynniki ryzyka AAA nie są identyczne z czynnikami ryzyka jego pęknięcia. Podczas gdy palenie tytoniu, nadciśnienie tętnicze i większa średnica tętniaka zwiększają ryzyko pęknięcia, istnieją również specyficzne czynniki wpływające na ryzyko rozwoju i przebiegu AAA.⁴³⁴⁴

Zrozumienie etiologii i czynników ryzyka tętniaka aorty brzusznej ma kluczowe znaczenie dla identyfikacji osób zagrożonych, wdrożenia odpowiednich programów przesiewowych oraz opracowania strategii profilaktyki i leczenia tego potencjalnie zagrażającego życiu schorzenia.⁴⁵

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Materiały źródłowe

#1 Aortic Aneurysm – Causes and Risk Factors | NHLBI, NIH
https://www.nhlbi.nih.gov/health/aortic-aneurysm/causes
You may have an increased risk of developing an aortic aneurysm because of your age, family history, genes, lifestyle habits, medical conditions, or sex. […] Your risk for aortic aneurysms goes up as you age. Abdominal aortic aneurysms are most common in adults after age 65. […] One in 10 people with abdominal aortic aneurysms have a family history of them. The chance of developing an abdominal aortic aneurysm is 1 in 5 for people who have a parent, brother, sister, or child with the condition, what is known as a first degree relative. […] Cigarette smoking is one of the main factors that increases your risk for an aortic aneurysm, especially an abdominal aortic aneurysm. If you are a current smoker, an abdominal aortic aneurysm may grow more quickly and be more likely to burst. […] High blood pressure, which is the leading risk factor for thoracic aortic aneurysms but also a risk factor for abdominal aortic aneurysm. […] Men are more likely than women to develop aortic aneurysms. However, an existing aneurysm is more likely to rupture at a smaller size in women than in men. […] Aortic abdominal aneurisms are less common in Hispanics, African Americans and Asian Americans.
#2 Abdominal aortic aneurysm | Radiology Reference Article | Radiopaedia.org
https://radiopaedia.org/articles/abdominal-aortic-aneurysm?lang=us
Abdominal aortic aneurysms (AAA) are focal dilatations of the abdominal aorta measuring 50% greater than the proximal normal segment or 3 cm in maximum diameter. […] Etiology includes atherosclerosis (most common), inflammatory abdominal aortic aneurysm, chronic aortic dissection, vasculitis, e.g. Takayasu arteritis, connective tissue disorders such as Marfan syndrome and Ehlers-Danlos syndrome, mycotic aneurysm, traumatic pseudoaneurysm, and anastomotic pseudoaneurysm.
#3 Abdominal aortic aneurysm – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/abdominal-aortic-aneurysm/symptoms-causes/syc-20350688
An aneurysm can grow in any part of the aorta. Most aortic aneurysms happen in the part of the aorta that’s in the belly area, called the abdomen. […] Things that can cause an abdominal aortic aneurysm include: […] Hardening of the arteries, called atherosclerosis. Atherosclerosis occurs when fat and other substances build up in and on the artery walls. […] High blood pressure. High blood pressure can damage and weaken the aorta’s walls. […] Blood vessel diseases. These diseases cause blood vessels to become swollen and irritated. […] Infection in the aorta. Rarely, germs can infect the aorta and cause an abdominal aortic aneurysm. […] Trauma. For example, being injured in a car accident can cause an abdominal aortic aneurysm.
#4 Abdominal Aortic Aneurysm (AAA) – Diagnosis and Treatment
https://www.radiologyinfo.org/en/info/abdoaneurysm
Abdominal aortic aneurysms typically develop slowly over a period of many years and hardly ever cause any noticeable symptoms. […] The majority of AAAs are the result of atherosclerosis, a chronic degenerative disease of the artery wall, in which fat, cholesterol, and other substances build up in the walls of arteries and form soft or hard deposits called plaques. […] Major risk factors for an AAA include family history, smoking and longstanding high blood pressure.
#5 Abdominal aortic aneurysm | NHS inform
https://www.nhsinform.scot/illnesses-and-conditions/a-to-z/abdominal-aortic-aneurysm/
Atherosclerosis is a potentially serious condition where arteries become clogged up by fatty deposits, such as cholesterol. […] An AAA is thought to develop because these deposits (called plaques) cause the aorta to widen in an attempt to keep blood flowing through it. As it widens, it also gets weaker. […] As well as contributing to atherosclerosis, high blood pressure (hypertension) can place increased pressure on the aorta’s wall. […] Having a family history of AAAs means that you have an increased risk of developing one. […] One study found that people who had a brother or sister with an AAA were eight times more likely to develop one than people whose siblings were unaffected.
#6 Abdominal Aortic Aneurysm | AAFP
https://www.aafp.org/pubs/afp/issues/2015/0415/p538.html
Abdominal aortic aneurysm refers to abdominal aortic dilation of 3.0 cm or greater. The main risk factors are age older than 65 years, male sex, and smoking history. Other risk factors include a family history of abdominal aortic aneurysm, coronary artery disease, hypertension, peripheral artery disease, and previous myocardial infarction. […] Aneurysms develop as a result of degeneration of the arterial media and elastic tissues. Risk factors for AAA are similar to those of other cardiovascular diseases. The key risk factors are male sex, smoking, age older than 65 years, coronary artery disease, hypertension, previous myocardial infarction, peripheral arterial disease, and a family history of AAA. […] Beyond the inherent risk of rupture, patients with AAA are also at an increased risk of cardiovascular disease and death independent of other factors. The degree to which risk factors impact AAA vs. atherosclerosis varies. For example, dyslipidemia is an important coronary artery disease risk factor, although its role in AAA remains uncertain, and diabetes mellitus may have a negative association with AAA.
#7 Abdominal aortic aneurysm: Screening, treatment, and symptoms
https://www.medicalnewstoday.com/articles/abdominal-aortic-aneurysm
A buildup of pressure in the artery and a weakening of the artery wall cause AAA. […] The pressure might build up due to atherosclerosis. This disease causes plaque, which is a fatty substance in the blood, to gather inside the arteries. […] As plaque gathers, it causes pressure to build up in the artery and can lead to an AAA developing. […] In some cases, an AAA might occur as a part of an inherited condition. For example, some genes can increase the risk of an AAA. Certain inherited disorders, such as Marfan syndrome and Ehlers-Danlos syndrome, may increase the risk of AAA. […] In other cases, an AAA may result from an injury, such as dissection, or an infection, such as syphilis.
#8 Aortic Aneurysm – Causes and Risk Factors | NHLBI, NIH
https://www.nhlbi.nih.gov/health/aortic-aneurysm/causes
You may have an increased risk of developing an aortic aneurysm because of your age, family history, genes, lifestyle habits, medical conditions, or sex. […] Your risk for aortic aneurysms goes up as you age. Abdominal aortic aneurysms are most common in adults after age 65. […] One in 10 people with abdominal aortic aneurysms have a family history of them. The chance of developing an abdominal aortic aneurysm is 1 in 5 for people who have a parent, brother, sister, or child with the condition, what is known as a first degree relative. […] Cigarette smoking is one of the main factors that increases your risk for an aortic aneurysm, especially an abdominal aortic aneurysm. If you are a current smoker, an abdominal aortic aneurysm may grow more quickly and be more likely to burst. […] High blood pressure, which is the leading risk factor for thoracic aortic aneurysms but also a risk factor for abdominal aortic aneurysm. […] Men are more likely than women to develop aortic aneurysms. However, an existing aneurysm is more likely to rupture at a smaller size in women than in men. […] Aortic abdominal aneurisms are less common in Hispanics, African Americans and Asian Americans.
#9 Abdominal Aortic Aneurysm: Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/7153-abdominal-aortic-aneurysm
An underlying weakness in your aortas wall causes an AAA to form. Many environmental and hereditary factors come together to cause this weakness. Overall, the exact reason they form isnt understood. […] For example, tobacco use causes your aortas wall to lose proteins that provide its structure. This reduces its strength. Your aortas wall can also grow weaker due to plaque buildup (atherosclerosis). Plaque formation and growth over time can cause inflammation and cell death in the layers of the artery wall. As the building blocks of your aortas wall break down, your aorta grows weaker and more vulnerable to abnormal expansion. […] These risk factors play the biggest role in determining who develops an AAA: History of tobacco use. Researchers define this as smoking at least 100 cigarettes during your lifetime. Your exact risk varies by use (the more you used tobacco, the higher your risk). Older age. You face a higher risk of an AAA as you get older (over age 50 for males, and over age 65 for females). Sex at birth. Males are more likely to develop an AAA. Family history of AAA. Family history plays an important role in the development of AAAs. About 10% to 20% of people who have a first-degree relative with an AAA also develop one. This means you face a higher risk if your biological parent, child or sibling had an AAA at some point in their life. The association is especially strong among male siblings. […] Other risk factors that can play a role include: High blood pressure. Having some form of atherosclerotic cardiovascular disease (ASCVD). This includes coronary artery disease (CAD) and peripheral artery disease (PAD). Having an inherited vascular connective-tissue disease.
#10 Aortic Aneurysm – Causes and Risk Factors | NHLBI, NIH
https://www.nhlbi.nih.gov/health/aortic-aneurysm/causes
You may have an increased risk of developing an aortic aneurysm because of your age, family history, genes, lifestyle habits, medical conditions, or sex. […] Your risk for aortic aneurysms goes up as you age. Abdominal aortic aneurysms are most common in adults after age 65. […] One in 10 people with abdominal aortic aneurysms have a family history of them. The chance of developing an abdominal aortic aneurysm is 1 in 5 for people who have a parent, brother, sister, or child with the condition, what is known as a first degree relative. […] Cigarette smoking is one of the main factors that increases your risk for an aortic aneurysm, especially an abdominal aortic aneurysm. If you are a current smoker, an abdominal aortic aneurysm may grow more quickly and be more likely to burst. […] High blood pressure, which is the leading risk factor for thoracic aortic aneurysms but also a risk factor for abdominal aortic aneurysm. […] Men are more likely than women to develop aortic aneurysms. However, an existing aneurysm is more likely to rupture at a smaller size in women than in men. […] Aortic abdominal aneurisms are less common in Hispanics, African Americans and Asian Americans.
#11 Abdominal Aortic Aneurysm – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK470237/
Risk factors for AAAs include atherosclerosis (the most common), smoking, advanced age, male sex, White race, family history of AAA, hypertension, hypercholesterolemia, and prior history of aortic dissection. […] Other causes include cystic medial necrosis, syphilis, human immunodeficiency virus, and connective tissue diseases (Ehlers-Danlos syndrome, Marfan syndrome, and Loeys-Dietz syndrome). […] Those of the non White race and those with diabetes are associated with a reduced risk for AAA.
#12 Aortic Aneurysm – Causes and Risk Factors | NHLBI, NIH
https://www.nhlbi.nih.gov/health/aortic-aneurysm/causes
You may have an increased risk of developing an aortic aneurysm because of your age, family history, genes, lifestyle habits, medical conditions, or sex. […] Your risk for aortic aneurysms goes up as you age. Abdominal aortic aneurysms are most common in adults after age 65. […] One in 10 people with abdominal aortic aneurysms have a family history of them. The chance of developing an abdominal aortic aneurysm is 1 in 5 for people who have a parent, brother, sister, or child with the condition, what is known as a first degree relative. […] Cigarette smoking is one of the main factors that increases your risk for an aortic aneurysm, especially an abdominal aortic aneurysm. If you are a current smoker, an abdominal aortic aneurysm may grow more quickly and be more likely to burst. […] High blood pressure, which is the leading risk factor for thoracic aortic aneurysms but also a risk factor for abdominal aortic aneurysm. […] Men are more likely than women to develop aortic aneurysms. However, an existing aneurysm is more likely to rupture at a smaller size in women than in men. […] Aortic abdominal aneurisms are less common in Hispanics, African Americans and Asian Americans.
#13 Abdominal Aortic Aneurysm: Practice Essentials, Anatomy, Pathophysiology
https://emedicine.medscape.com/article/1979501-overview
Less frequent causes of AAA include Marfan syndrome, Ehlers-Danlos syndrome, and other collagen-vascular diseases. […] In fewer than 5% of cases, AAA is caused by a mycotic aneurysm of hematogenous origin. […] In these cases, local invasion of the intima and media gives rise to abscess formation and aneurysmal dilation of the vessel. […] Gram-positive organisms most commonly cause mycotic aneurysms. […] Other uncommon causes include cystic medial necrosis, arteritis, trauma, and anastomotic disruption producing pseudoaneurysms. […] Persons who have first-degree relatives with AAA are at increased risk for AAA. […] The familial prevalence rate of AAA has been estimated at 15-25%. […] Studies by Majumder et al suggested that the genetic predisposition is isolated to a single dominant gene with low penetrance that increases with age.
#14 Abdominal Aortic Aneurysm (AAA) Causes | Stanford Health Care
https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/abdominal-aortic-aneurysm/causes.html
An abdominal aortic aneurysm may be caused by multiple factors that result in the breaking down of the well-organized proteins of the aortic wall that provide support and stabilize the wall. The exact cause is not fully known. […] Atherosclerosis (a build-up of plaque, which is a deposit of fatty substances, cholesterol, cellular waste products, calcium, and fibrin in the inner lining of an artery) may also be a cause of abdominal aortic aneurysms. […] Both atherosclerosis and AAA may share the same risk factors including: Age (greater than 60), Male (occurrence in males is four to five times greater than that of females), Family history (first degree relatives such as father or brother), Genetic factors, Hyperlipidemia (elevated fats in the blood), Hypertension (high blood pressure), Smoking, Diabetes. […] Related conditions that may cause AAA include genetic disorders of connective tissue, congenital syndromes, giant cell arteritis, trauma or previous surgery, and infectious aortitis (infections of the aorta).
#15 Abdominal Aortic Aneurysm: Practice Essentials, Anatomy, Pathophysiology
https://emedicine.medscape.com/article/1979501-overview
Tilson et al described the potential for an autoimmune basis for the development of AAA involving the DRB1 major histocompatibility locus. […] This locus has been identified as a basis for inflammatory AAA. […] In late 2018, the FDA issued a warning that fluoroquinolone use can increase the risk of aortic aneurysm and urged healthcare providers to avoid prescribing these antibiotics to patients with or at risk for an aortic aneurysm, such as those with peripheral atherosclerotic vascular disease, hypertension, or certain genetic conditions (eg, Marfan syndrome and Ehlers-Danlos syndrome), as well as the elderly.
#16 Aortic Aneurysm – Causes and Risk Factors | NHLBI, NIH
https://www.nhlbi.nih.gov/health/aortic-aneurysm/causes
You may have an increased risk of developing an aortic aneurysm because of your age, family history, genes, lifestyle habits, medical conditions, or sex. […] Your risk for aortic aneurysms goes up as you age. Abdominal aortic aneurysms are most common in adults after age 65. […] One in 10 people with abdominal aortic aneurysms have a family history of them. The chance of developing an abdominal aortic aneurysm is 1 in 5 for people who have a parent, brother, sister, or child with the condition, what is known as a first degree relative. […] Cigarette smoking is one of the main factors that increases your risk for an aortic aneurysm, especially an abdominal aortic aneurysm. If you are a current smoker, an abdominal aortic aneurysm may grow more quickly and be more likely to burst. […] High blood pressure, which is the leading risk factor for thoracic aortic aneurysms but also a risk factor for abdominal aortic aneurysm. […] Men are more likely than women to develop aortic aneurysms. However, an existing aneurysm is more likely to rupture at a smaller size in women than in men. […] Aortic abdominal aneurisms are less common in Hispanics, African Americans and Asian Americans.
#17 Abdominal aortic aneurysm | NHS inform
https://www.nhsinform.scot/illnesses-and-conditions/a-to-z/abdominal-aortic-aneurysm/
The bulging occurs when the wall of the aorta weakens. Although what causes this weakness is unclear, smoking and high blood pressure are thought to increase the risk of an aneurysm. […] Its not known exactly what causes the aortic wall to weaken, although increasing age and being male are known to be the biggest risk factors. […] There are other risk factors you can do something about, including smoking and having high blood pressure and cholesterol level. […] Having a family history of aortic aneurysms also means that you have an increased risk of developing one yourself. […] Research has found that smokers are seven times more likely to develop an AAA than people who have never smoked. […] The risk may increase because tobacco smoke contains harmful substances that can damage and weaken the wall of the aorta.
#18 About Aortic Aneurysm | Heart Disease | CDC
https://www.cdc.gov/heart-disease/about/aortic-aneurysm.html
Aortic aneurysms are usually caused by atherosclerosis (hardened arteries), but infection or injury can also cause them. […] A history of smoking accounts for about 75% of all abdominal aortic aneurysms. […] Diseases and unhealthy behaviors that damage your heart and blood vessels also increase your risk for aortic aneurysm. Smoking is the most important behavior related to aortic aneurysm. […] Other factors include high blood pressure, high blood cholesterol, and atherosclerosis (hardened arteries). […] Some inherited connective tissue disorders, such as Marfan syndrome and Ehlers-Danlos syndrome, can also increase your risk for aortic aneurysm.
#19 The Most Common Cause of an Abdominal Aortic Aneurysm
https://www.southvalleyvascular.com/post/the-most-common-cause-of-an-abdominal-aortic-aneurysm
An abdominal aortic aneurysm is caused by a weakness in the wall of the aorta. […] The number one risk factor for this medical issue is smoking. Smokers die four times more often from a ruptured aneurysm than non-smokers. […] Family history is another major risk factor, as are high blood pressure and old age. […] The best thing you can do to avoid developing an aneurysm is to not smoke. Smoking is the most common cause of an abdominal aortic aneurysm as well as many other health problems.
#20 Abdominal Aortic Aneurysm (AAA) Causes | Stanford Health Care
https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/abdominal-aortic-aneurysm/causes.html
An abdominal aortic aneurysm may be caused by multiple factors that result in the breaking down of the well-organized proteins of the aortic wall that provide support and stabilize the wall. The exact cause is not fully known. […] Atherosclerosis (a build-up of plaque, which is a deposit of fatty substances, cholesterol, cellular waste products, calcium, and fibrin in the inner lining of an artery) may also be a cause of abdominal aortic aneurysms. […] Both atherosclerosis and AAA may share the same risk factors including: Age (greater than 60), Male (occurrence in males is four to five times greater than that of females), Family history (first degree relatives such as father or brother), Genetic factors, Hyperlipidemia (elevated fats in the blood), Hypertension (high blood pressure), Smoking, Diabetes. […] Related conditions that may cause AAA include genetic disorders of connective tissue, congenital syndromes, giant cell arteritis, trauma or previous surgery, and infectious aortitis (infections of the aorta).
#21 Abdominal Aortic Aneurysm: Practice Essentials, Anatomy, Pathophysiology
https://emedicine.medscape.com/article/1979501-overview
AAA is thought to be a degenerative process of the aorta, the cause of which remains unclear. […] It is often attributed to atherosclerosis because these changes are observed in the aneurysm at the time of surgery. […] However, a study by Blanchard et al found that the risk factors for AAA differ from those for atherosclerosis, with no association between cholesterol and AAA. […] In addition, atherosclerosis fails to explain the development of occlusion, which is observed in the disease process. […] Patients at greatest risk for AAA are men who are older than 65 years and have peripheral atherosclerotic vascular disease. […] A history of smoking often is elicited. […] Other risk factors for AAA include the following: Chronic obstructive pulmonary disease (COPD), Previous aneurysm repair or peripheral aneurysm (popliteal prevalence at 62% or femoral prevalence at 85%), Coronary artery disease, Hypertension (1-15% of cases).
#22 Abdominal aortic aneurysm
https://www.nhs.uk/conditions/abdominal-aortic-aneurysm/
An abdominal aortic aneurysm happens when the main artery that carries blood from the heart to the tummy (the aorta) becomes weakened. […] It’s not always clear what causes it, but some people have a higher chance of getting one. […] You’re more at risk if you: are male and aged 65 or over, smoke or used to smoke, have high blood pressure, have high cholesterol, have a close relative who’s had an abdominal aortic aneurysm, have coronary or peripheral artery disease (atherosclerosis), have chronic obstructive pulmonary disease (COPD), have a condition such as Marfan syndrome. […] Sometimes an abdominal aortic aneurysm can be caused by an infection, but this is rare.
#23 Abdominal Aortic Aneurysm – Clinical Features – TeachMeSurgery
https://teachmesurgery.com/vascular/arterial/abdominal-aorta-aneurysm/
The aetiology of abdominal aortic aneurysm is largely unknown. Possible causes include atherosclerosis, trauma, infection, connective tissue disease (e.g. Marfans disease, Ehlers Danlos), or inflammatory disease (e.g. Takayasus aortitis). […] Risk factors for AAA include smoking, hypertension, hyperlipidaemia, family history, male gender, and increasing age. Diabetes mellitus is a negative risk factor for AAA (the mechanism for this is poorly understood).
#24 Abdominal Aortic Aneurysm – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK470237/
Risk factors for AAAs include atherosclerosis (the most common), smoking, advanced age, male sex, White race, family history of AAA, hypertension, hypercholesterolemia, and prior history of aortic dissection. […] Other causes include cystic medial necrosis, syphilis, human immunodeficiency virus, and connective tissue diseases (Ehlers-Danlos syndrome, Marfan syndrome, and Loeys-Dietz syndrome). […] Those of the non White race and those with diabetes are associated with a reduced risk for AAA.
#25 Aortic aneurysms: current pathogenesis and therapeutic targets | Experimental & Molecular Medicine
https://www.nature.com/articles/s12276-023-01130-w
Aortic aneurysm is a chronic disease characterized by localized expansion of the aorta, including the ascending aorta, arch, descending aorta, and abdominal aorta. […] Aortic aneurysms are generally classified as thoracic aortic aneurysms (TAAs), which form in the ascending aorta, the arch, or the aorta above the diaphragm, or abdominal aortic aneurysms (AAAs), which are localized in the aorta below the diaphragm in the supra- or infrarenal regions. […] Although distinct pathological mechanisms are present in TAA and AAA, many risk factors for aortic aneurysms are shared, including age, smoking, hypertension, hyperlipidemia, male sex, white race, and a positive family history. […] Multiple pathological processes, including extracellular matrix (ECM) breakdown, inflammation, phenotype switching of vascular smooth muscle cells (SMCs), oxidative stress, and neovascularization, contribute to this process.
#26 Aortic aneurysms: current pathogenesis and therapeutic targets | Experimental & Molecular Medicine
https://www.nature.com/articles/s12276-023-01130-w
The loss of structural integrity due to vascular SMC dysfunction, including apoptosis and ECM degradation, leads to weakness and dilatation of the aortic wall, which are hallmarks of aortic aneurysm. […] An imbalance in reparative/ECM production and inflammatory/ECM degradation in SMCs that underwent phenotypic switching and are known as synthetic SMCs in response to constant pathological stimuli damages the aortic wall, leading to dilatation and rupture in aortic aneurysms. […] The components of the transforming growth factor- (TGF-) signaling pathway, including receptors and SMAD proteins, are fundamental for synthesizing SMC contractile proteins, ECM proteins, elastin, and collagen. […] Mutations in the genes involved in the canonical TGF- signaling pathway, including TGFBR1, TGFBR2, SMAD3, SMAD4, and TGF-2, have been identified as predisposing factors for aortic aneurysms and dissections with Marfanoid features.
#27 Aortic aneurysms: current pathogenesis and therapeutic targets | Experimental & Molecular Medicine
https://www.nature.com/articles/s12276-023-01130-w
Vascular inflammation is the main initiating factor in aortic aneurysms and substantially influences aortic wall remodeling through the death of aortic wall cells, SMC phenotypic switching, and the secretion of proteases. […] Cytokines are crucial contributors to inflammatory alterations during AAA formation, and altered expression and epigenetic changes in cytokines were present in AAA tissue samples. […] The upregulation of TLR2 and its ligands was identified in human AAA tissue, and antagonism of TLR2 in a mouse model decreased the formation and progression of AAA and inhibited chronic inflammation and vascular remodeling. […] Neutrophil extracellular traps (NETs) promote AAA formation by inducing ferroptosis in SMCs by inhibiting the phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT) pathway, and ferrostatin-1, an inhibitor of ferroptosis, prevents AAA formation.
#28
https://step2.medbullets.com/cardiovascular/120031/abdominal-aortic-aneurysm
Abdominal aortic aneurysm (AAA) is a condition characterized by a segmental and full-thickness dilation of the abdominal aorta. It is caused by inflammation and stress upon the aortic wall leading to dilatation and aneurysm. […] Inflammation leads to the degradation of proteins within connective tissue. […] Aortic wall loses structural integrity. […] Vessels widen and dilate leading to dilation and rupture. […] Weakening of the aortic wall can lead to tears causing aortic dissection. […] Severe aneurysms can ultimately lead to aortic rupture. […] Elastin fibers become disrupted and collagen becomes degraded, resulting in a loss of elasticity in the aortic wall.
#29 Abdominal Aortic Aneurysms (AAA) – Cardiovascular Disorders – Merck Manual Professional Edition
https://www.merckmanuals.com/professional/cardiovascular-disorders/diseases-of-the-aorta-and-its-branches/abdominal-aortic-aneurysms-aaa
Etiology of abdominal aortic aneurysms is multifactorial but commonly involves a weakening of the arterial wall, usually by […] Atherosclerosis. Other causes include […] Trauma, […] Cystic medial necrosis (degeneration of the aortic media), […] Postsurgical anastomotic disruption, […] Vasculitis (eg, Takayasu arteritis). Uncommonly, syphilis and localized bacterial or fungal infection, typically due to sepsis or infective endocarditis, weaken the arterial wall and cause infected (mycotic) aneurysms. Staphylococcus aureus is the number one cause of mycotic aneurysms, followed by Salmonella.
#30 Abdominal Aortic Aneurysm: Practice Essentials, Anatomy, Pathophysiology
https://emedicine.medscape.com/article/1979501-overview
Less frequent causes of AAA include Marfan syndrome, Ehlers-Danlos syndrome, and other collagen-vascular diseases. […] In fewer than 5% of cases, AAA is caused by a mycotic aneurysm of hematogenous origin. […] In these cases, local invasion of the intima and media gives rise to abscess formation and aneurysmal dilation of the vessel. […] Gram-positive organisms most commonly cause mycotic aneurysms. […] Other uncommon causes include cystic medial necrosis, arteritis, trauma, and anastomotic disruption producing pseudoaneurysms. […] Persons who have first-degree relatives with AAA are at increased risk for AAA. […] The familial prevalence rate of AAA has been estimated at 15-25%. […] Studies by Majumder et al suggested that the genetic predisposition is isolated to a single dominant gene with low penetrance that increases with age.
#31 Aortic Aneurysm: Symptoms, Causes & Treatment
https://my.clevelandclinic.org/health/diseases/16742-aorta-aortic-aneurysm
An aortic aneurysm develops when there’s a weakness in the wall of your aorta. […] The causes of an aortic aneurysm are often unknown, but can include: Atherosclerosis (narrowing of the arteries). […] Inherited conditions, especially those that affect connective tissue (such as Marfan syndrome and Ehlers-Danlos syndrome). […] Injury to an aorta. […] Infections, such as syphilis.
#32 Abdominal aortic aneurysm – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/abdominal-aortic-aneurysm/symptoms-causes/syc-20350688
An aneurysm can grow in any part of the aorta. Most aortic aneurysms happen in the part of the aorta that’s in the belly area, called the abdomen. […] Things that can cause an abdominal aortic aneurysm include: […] Hardening of the arteries, called atherosclerosis. Atherosclerosis occurs when fat and other substances build up in and on the artery walls. […] High blood pressure. High blood pressure can damage and weaken the aorta’s walls. […] Blood vessel diseases. These diseases cause blood vessels to become swollen and irritated. […] Infection in the aorta. Rarely, germs can infect the aorta and cause an abdominal aortic aneurysm. […] Trauma. For example, being injured in a car accident can cause an abdominal aortic aneurysm.
#33 Abdominal Aortic Aneurysm: Practice Essentials, Anatomy, Pathophysiology
https://emedicine.medscape.com/article/1979501-overview
Tilson et al described the potential for an autoimmune basis for the development of AAA involving the DRB1 major histocompatibility locus. […] This locus has been identified as a basis for inflammatory AAA. […] In late 2018, the FDA issued a warning that fluoroquinolone use can increase the risk of aortic aneurysm and urged healthcare providers to avoid prescribing these antibiotics to patients with or at risk for an aortic aneurysm, such as those with peripheral atherosclerotic vascular disease, hypertension, or certain genetic conditions (eg, Marfan syndrome and Ehlers-Danlos syndrome), as well as the elderly.
#34 Aortic aneurysms: current pathogenesis and therapeutic targets | Experimental & Molecular Medicine
https://www.nature.com/articles/s12276-023-01130-w
Aortic aneurysm is a chronic disease characterized by localized expansion of the aorta, including the ascending aorta, arch, descending aorta, and abdominal aorta. […] Aortic aneurysms are generally classified as thoracic aortic aneurysms (TAAs), which form in the ascending aorta, the arch, or the aorta above the diaphragm, or abdominal aortic aneurysms (AAAs), which are localized in the aorta below the diaphragm in the supra- or infrarenal regions. […] Although distinct pathological mechanisms are present in TAA and AAA, many risk factors for aortic aneurysms are shared, including age, smoking, hypertension, hyperlipidemia, male sex, white race, and a positive family history. […] Multiple pathological processes, including extracellular matrix (ECM) breakdown, inflammation, phenotype switching of vascular smooth muscle cells (SMCs), oxidative stress, and neovascularization, contribute to this process.
#35
https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=hw57497
The wall of the aorta is normally very elastic. It can stretch and then shrink back as needed to adapt to blood flow. But some medical problems, such as atherosclerosis and certain infections, weaken the artery walls. These problems, along with the natural wear and tear of aging, can cause an aneurysm. […] The wall of the aorta is normally very elastic. It can stretch and then shrink back as needed to adapt to blood flow. But some things weaken the artery walls and can cause an aneurysm. These things include: Atherosclerosis. Exactly how atherosclerosis, or hardening of the arteries, leads to aortic aneurysms isn’t clear. It may cause changes in the lining of the artery wall that lead to tissue damage. […] Certain inherited conditions can affect the arteries. These conditions include Marfan syndrome and Ehlers-Danlos syndrome. […] The aorta naturally becomes less elastic and stiffer with age. […] Some infections can cause aneurysms. Examples include syphilis and endocarditis. […] A sudden, intense blow to the chest or belly can damage the aorta. […] But what causes the aorta to become inflamed isn’t clear.
#36
https://step2.medbullets.com/cardiovascular/120031/abdominal-aortic-aneurysm
Abdominal aortic aneurysm (AAA) is a condition characterized by a segmental and full-thickness dilation of the abdominal aorta. It is caused by inflammation and stress upon the aortic wall leading to dilatation and aneurysm. […] Inflammation leads to the degradation of proteins within connective tissue. […] Aortic wall loses structural integrity. […] Vessels widen and dilate leading to dilation and rupture. […] Weakening of the aortic wall can lead to tears causing aortic dissection. […] Severe aneurysms can ultimately lead to aortic rupture. […] Elastin fibers become disrupted and collagen becomes degraded, resulting in a loss of elasticity in the aortic wall.
#37 Abdominal Aortic Aneurysm: Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/7153-abdominal-aortic-aneurysm
An underlying weakness in your aortas wall causes an AAA to form. Many environmental and hereditary factors come together to cause this weakness. Overall, the exact reason they form isnt understood. […] For example, tobacco use causes your aortas wall to lose proteins that provide its structure. This reduces its strength. Your aortas wall can also grow weaker due to plaque buildup (atherosclerosis). Plaque formation and growth over time can cause inflammation and cell death in the layers of the artery wall. As the building blocks of your aortas wall break down, your aorta grows weaker and more vulnerable to abnormal expansion. […] These risk factors play the biggest role in determining who develops an AAA: History of tobacco use. Researchers define this as smoking at least 100 cigarettes during your lifetime. Your exact risk varies by use (the more you used tobacco, the higher your risk). Older age. You face a higher risk of an AAA as you get older (over age 50 for males, and over age 65 for females). Sex at birth. Males are more likely to develop an AAA. Family history of AAA. Family history plays an important role in the development of AAAs. About 10% to 20% of people who have a first-degree relative with an AAA also develop one. This means you face a higher risk if your biological parent, child or sibling had an AAA at some point in their life. The association is especially strong among male siblings. […] Other risk factors that can play a role include: High blood pressure. Having some form of atherosclerotic cardiovascular disease (ASCVD). This includes coronary artery disease (CAD) and peripheral artery disease (PAD). Having an inherited vascular connective-tissue disease.
#38 Aortic aneurysms: current pathogenesis and therapeutic targets | Experimental & Molecular Medicine
https://www.nature.com/articles/s12276-023-01130-w
Vascular inflammation is the main initiating factor in aortic aneurysms and substantially influences aortic wall remodeling through the death of aortic wall cells, SMC phenotypic switching, and the secretion of proteases. […] Cytokines are crucial contributors to inflammatory alterations during AAA formation, and altered expression and epigenetic changes in cytokines were present in AAA tissue samples. […] The upregulation of TLR2 and its ligands was identified in human AAA tissue, and antagonism of TLR2 in a mouse model decreased the formation and progression of AAA and inhibited chronic inflammation and vascular remodeling. […] Neutrophil extracellular traps (NETs) promote AAA formation by inducing ferroptosis in SMCs by inhibiting the phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT) pathway, and ferrostatin-1, an inhibitor of ferroptosis, prevents AAA formation.
#39 Abdominal Aortic Aneurysm Causes
https://www.spine-health.com/conditions/lower-back-pain/abdominal-aortic-aneurysm-causes
A single, underlying cause for abdominal aortic aneurysms is unknown. Many known factors may lead to an abdominal aortic aneurysm developing: cardiovascular problems, genetic conditions, family history, and lifestyle and health habits. […] Cholesterol build-up may contribute to the development of abdominal aortic aneurysms. […] The conditions associated with a heightened risk for abdominal aortic aneurysm include the following: Atherosclerosis. This condition occurs when plaque buildup in the bloodstream causes the bodys blood vessels to harden and narrow. Atherosclerosis may develop during young adulthood but only becomes problematic later in life. […] High cholesterol. Cholesterol may build up in the blood vessels, which can narrow the bloodstream and harden the arterial walls. […] High blood pressure. A sustained increased force of blood moving through the aorta can weaken the artery walls.
#40 Abdominal aortic aneurysm Information | Mount Sinai – New York
https://www.mountsinai.org/health-library/diseases-conditions/abdominal-aortic-aneurysm
The exact cause of an aneurysm is unknown. It occurs due to weakness in the wall of the artery. Factors that can increase your risk of having this problem include: […] An abdominal aortic aneurysm is most often seen in males over age 60 who have one or more risk factors. The larger the aneurysm, the more likely it is to break open or tear. This can be life threatening.
#41 Abdominal Aortic Aneurysm | AAFP
https://www.aafp.org/pubs/afp/issues/2015/0415/p538.html
Abdominal aortic aneurysm refers to abdominal aortic dilation of 3.0 cm or greater. The main risk factors are age older than 65 years, male sex, and smoking history. Other risk factors include a family history of abdominal aortic aneurysm, coronary artery disease, hypertension, peripheral artery disease, and previous myocardial infarction. […] Aneurysms develop as a result of degeneration of the arterial media and elastic tissues. Risk factors for AAA are similar to those of other cardiovascular diseases. The key risk factors are male sex, smoking, age older than 65 years, coronary artery disease, hypertension, previous myocardial infarction, peripheral arterial disease, and a family history of AAA. […] Beyond the inherent risk of rupture, patients with AAA are also at an increased risk of cardiovascular disease and death independent of other factors. The degree to which risk factors impact AAA vs. atherosclerosis varies. For example, dyslipidemia is an important coronary artery disease risk factor, although its role in AAA remains uncertain, and diabetes mellitus may have a negative association with AAA.
#42 Abdominal Aortic Aneurysm (AAA) Causes | Stanford Health Care
https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/abdominal-aortic-aneurysm/causes.html
An abdominal aortic aneurysm may be caused by multiple factors that result in the breaking down of the well-organized proteins of the aortic wall that provide support and stabilize the wall. The exact cause is not fully known. […] Atherosclerosis (a build-up of plaque, which is a deposit of fatty substances, cholesterol, cellular waste products, calcium, and fibrin in the inner lining of an artery) may also be a cause of abdominal aortic aneurysms. […] Both atherosclerosis and AAA may share the same risk factors including: Age (greater than 60), Male (occurrence in males is four to five times greater than that of females), Family history (first degree relatives such as father or brother), Genetic factors, Hyperlipidemia (elevated fats in the blood), Hypertension (high blood pressure), Smoking, Diabetes. […] Related conditions that may cause AAA include genetic disorders of connective tissue, congenital syndromes, giant cell arteritis, trauma or previous surgery, and infectious aortitis (infections of the aorta).
#43 The abdominal aortic artery aneurysm and cardiovascular risk factors
https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-18/the-abdominal-aortic-artery-aneurysm-and-cardiovascular-risk-factors
Abdominal aortic aneurysm (AAA) is a dilatation of its lumen over 3 cm or more than 50% larger than normal, occurring after 55 years of age, and more commonly found in men than in women. […] The main risk factors for the development of AAAs are smoking, hypertension, older age, male gender, atherosclerosis, dyslipidaemia, positive family history, and hereditary predisposition. […] Many pieces of evidence show that smoking is the major and strongest predictor of the prevalence, growth, and rupture rates of AAAs. […] The risk factors for AAA development are not strictly identical to the risk factors for rupture. […] Other causes of the development of AAAs include trauma, infection and arteritis. […] In the case of an AAA, the role of genetic factors is smaller than in the case of thoracic aortic aneurysms. […] Marfan syndrome and Ehlers-Danlos syndrome have also been strongly associated with AAAs.
#44 Azthena logo with the word Azthena
https://www.news-medical.net/health/Abdominal-Aortic-Aneurysm-(AAA)-Causes-Symptoms-Management.aspx
Aneurysms can occur anywhere in the body; however, the most common sites for aneurysms are in the abdominal aorta and the brain. The exact cause of the weakening of the vessel walls is unknown. However, several risk factors that may contribute to the weakening of blood vessel walls have been identified. […] Risk factors include: Smoking (by far the greatest risk factor for AAA), Hypertension (high blood pressure), Atherosclerosis (hardening of the arteries), Any disease that causes chronic inflammation of the arteries. […] Smokers have a higher rate of abdominal aorta aneurysms than non-smokers, with around 8 times higher risk of developing AAA compared to non-smokers. Smoking is more detrimental as a risk factor in women than in men, and the risk reduces gradually after cessation of smoking. […] The risk of rupture of the abdominal aortic aneurysm increases with size, wherein aneurysms larger than 6 cm have a 25% annual risk of rupture.
#45 Abdominal Aortic Aneurysm | AAFP
https://www.aafp.org/pubs/afp/issues/2015/0415/p538.html
Abdominal aortic aneurysm refers to abdominal aortic dilation of 3.0 cm or greater. The main risk factors are age older than 65 years, male sex, and smoking history. Other risk factors include a family history of abdominal aortic aneurysm, coronary artery disease, hypertension, peripheral artery disease, and previous myocardial infarction. […] Aneurysms develop as a result of degeneration of the arterial media and elastic tissues. Risk factors for AAA are similar to those of other cardiovascular diseases. The key risk factors are male sex, smoking, age older than 65 years, coronary artery disease, hypertension, previous myocardial infarction, peripheral arterial disease, and a family history of AAA. […] Beyond the inherent risk of rupture, patients with AAA are also at an increased risk of cardiovascular disease and death independent of other factors. The degree to which risk factors impact AAA vs. atherosclerosis varies. For example, dyslipidemia is an important coronary artery disease risk factor, although its role in AAA remains uncertain, and diabetes mellitus may have a negative association with AAA.