Increased Cardiovascular Risk in First-Degree Relatives (Without Abdominal Aortic Aneurysm

Increased cardiovascular risk in first-degree relatives (without abdominal aortic aneurysm, AAA) to AAA patients?

Rachel De Basso1,2, Anna Fagerlind2, Thomas Sandgren3, Åsa Rydén Ahlgren4 och Toste Länne1

1. Department of Physiology, LinköpingUniversity, Linköping, Sweden

2. Department of Clinical Physiology, JönköpingHospital, Jönköping, Sweden

3. Department of Surgery, Helsingborgs lasarett, Helsingborg, Sweden

4. Department of Clinical Physiology, Universitetssjukhuset MAS, Malmö, Sweden

ABSTRACT

Background: Patients with abdominal aortic aneurysm (AAA) have increased arterial wall stiffness, which is associated with increased cardiac morbidity and mortality. There is a genetic predisposition for AAA, but it is unknown whether first-degree relatives (without AAA), have a generalized dilating diathesis, or defect arterial wall mechanics. The aim of the study was to investigate the arterial diameter and wall properties in first-degree relatives (without AAA) to AAA patients, and compare them with controls without a family history of AAA.

Materials and Methods: 71 non-smoking first-degree relatives (without AAA) to patients with AAA (41 males, 41-68 years and 30 females, 52-70 years) and 66 controls matched for age and sex were included. An ultrasound echo-tracking system was used to measure diameter, pulsatile diameter changes in the abdominal aorta, the carotid, the common femoral, and the popliteal artery. In combination with blood pressure, strain, distensibility coefficient (DC) and compliance coefficient (CC) were calculated.

Results: No arterial dilatation either in central or in peripheral arteries was found, but rather a tendency of narrowing. The heart rate was significantly increased in the relatives (P<0.001). Systolic pressure was increased in male relatives, and diastolic pressure was increased in both genders. In male relatives, vascular stiffness was increased in all arterial territories. In female relatives vascular stiffness was increased, but only in the aorta. After adjusting blood pressure for heart rate, diastolic and mean pressures were still increased. After adjustingarterial stiffness for mean arterial pressure and heart rate, stiffness was normalized in all arterial territories.

Conclusion: No arterial dilatation in first-degree relatives (without AAA) to AAA patients can be found, supporting the hypothesis that the dilating diathesis is linked to the aneurysmal manifestation in the abdominal aorta. Although the threat of aneurysmal dilatation and rupture seems to be lacking, there are however signs of incipient peripheral atherosclerosis, increased blood pressure, heart rate and arterial wall stiffness, indicating increased cardiovascular risk in this population.