Prevalencia del aneurisma de aorta abdominal en varones de 65-80 años de una población rural / Prevalence of abdominal aortic aneurysm in a rural population of 65-80 year-old males

RESUMEN

Introducción. La prevalencia del aneurisma de aorta abdominal (AAA) es del 3,5-4% en varones mayores de 65 años. Se desconoce si esa prevalencia es extrapolable a una población rural, resultante de las mediciones ecográficas realizadas por médicos de familia. Objetivo. Estimar la prevalencia de AAA en una población rural de varones con edades de 65 a 80 años, mediante ecografía abdominal realizada por médicos de familia e identificar su asociación con diferentes FRV. Sujetos y método. Estudio transversal. Se incluyeron varones de 65 a 80 años (n = 320), de una población rural de la provincia de Ciudad Real. La variable dependiente, presencia o no de AAA, se consideró como un diámetro mayor o igual a 3 cms a la exploración ecográfica. Variables explicativas índice tobillo/brazo (ITB), índice de masa corporal (IMC), antecedentes de hipertensión arterial (HTA), diabetes mellitus (DM), dislipemia (DLP), cardiopatía isquémica, accidentes cerebrovaculares, tabaquismo. Se realizó un análisis bivariante, multivariante, de prevalencias y además un estudio de concordancia entre observadores. Resultados. La prevalencia de AAA fue 3,3% con un IC95% 1,1-5,5%. La DM y la DLP presentó una asociación significativa e independiente con el AAA (OR 5,19; IC95% 1,42-18,95). La concordancia entre observadores fue muy alta (CCI 0,96 (IC95% 0,91-0,98). Conclusiones. La prevalencia obtenida es similar a la encontrada en la literatura. Debido al diseño transversal del estudio, tanto FRV como la HTA o la EAP no presentan asociación con el AAA. Se podría crear un programa de detección precoz desde Atención Primaria por médicos de familia para el AAA (AU)

ABSTRACT

Introduction. The prevalence of aortic aneurysm (AAA) is reported to be 3.55%-4% in men over 65. But it is not known if this prevalence, resulting from ultrasound measurements made by Family Physicians, can be extrapolated to a rural population. Objective. To estimate the prevalence of AAA in a rural population of males aged 65-80 years, using abdominal ultrasound by family physicians, and to identify its association with different cardiovascular risk factors. Subjects and method. A cross sectional study was conducted that included males of 65-80 years (n = 320) in a rural population of the province of Ciudad Real, Spain. The dependent variable was the presence or not of AAA using ultrasound measurements of the aorta. Those with a diameter greater than or equal to 3 cm were considered positive. Explanatory variables were measured; ankle/brachial index (ABI), body mass index (BMI), medical history of high blood pressure (hypertension), diabetes mellitus (DM), dyslipidaemia (DLP), ischemic heart disease, cerebrovascular accidents (CVA), and smoking habits. A bivariate and multivariate analysis of the prevalences was performed, as well as a study of the agreement between observers. Results. The prevalence of AAA in the population was 3.3% (95% CI 1.1-5.5%. DM and DLP were significantly associated with AAA. The agreement between observers was 0.96 (95% CI; 0.91-0.98). The high prevalence of different cardiovascular risk factors (CVRF) was particularly noteworthy. Conclusions. The prevalence of AAA in 65-80 year-old males in a rural population is similar to that found in the literature. Due to the cross-sectional nature of the study, CVRFs such as hypertension or CVA were not associated with the AAA. A screening program for the early detection of AAA could be introduced into Primary Health Care by family physicians (AU)