Chapter 2: Cardiovascular Disorders

ACC/AHA

• Age ≥ 65 y who have ever smoked, or who are first-degree relatives of patients with AAA

• Age < 65 y who have multiple risk factors (smoking history, HTN, dyslipidemia, White race, inherited vascular connective tissue disorder, ASCVD) or a first-degree relative with AAA

• Age ≥ 65 y who have ever smoked, or who are first-degree relatives of patients with AAA

• Age < 65 y who have multiple risk factors (smoking history, HTN, dyslipidemia, White race, inherited vascular connective tissue disorder, ASCVD) or a first-degree relative with AAA

USPSTF

• Age 65–75 y if ever smoked

• Selectively offer screening if no smoking history

• Do not screen if no smoking or family history of AAA

• Insufficient evidence to assess benefits/harms if smoker or positive family history

SVS

• Age 65–75 y if ever smoked or first-degree relative with AAA

• Consider >75 y if in good health and not yet screened

• Screen once age 65–75 y if ever smoked or first-degree relative with AAA

• Consider screening >75 y if in good health and not yet screened

CSVS

• Age 65–80 y regardless of smoking history

• Screen once age 65–80 y if ever smoked or has cardiovascular disease

ESVS

• Age 65 y regardless of smoking history

• Do not screen

ACRa, AIUM, SRU

• Age ≥ 65 y regardless of history

• ≥50 y with family history of aortic and/or peripheral vascular aneurysmal disease or personal history of aneurysmal disease

• Screen once age ≥ 65 y if positive cardiovascular risk factors

• Screen once age ≥ 50 y with personal or family history of aortic and/or peripheral vascular aneurysmal disease

NICE

• Age > 65 y with COPD, CAD/CVD/PAD, family history of AAA, dyslipidemia, HTN, smoking (current or former)

• Age ≥ 70 y with COPD, CAD/PAD/CVD, family history of AAA, dyslipidemia, HTN, smoking (current or former)

ESC

• >65 y regardless of history

• Consider >65 y only if smoking history

• Applying to Clinical Practice

  • Screen male smokers older than age 65.

  • Consider screening nonsmoking men with strong family history.

  • Women: The prevalence of AAA is 6 times lower in women than men,^a lessening the potential benefit for population-based screening. Consider screening very high-risk women, since AAA may rupture somewhat more frequently in women than men.

  • Older patients may have higher operative morbidity if asymptomatic AAA is found, which accounts for the upper limit of the screening ages.

• ^aScott RA, ...