Factors associated with development of large abdominal aortic aneurysm in middle-aged men. Short title: Associated factors for development of AAA

We investigated whether any variables in a health-screened population study were associated with later development of large abdominal aortic aneurysms (AAA). Material and methods: Within the Malmö Preventive Study 22 444 men and 10 982 women were investigated between 1974 and 1991. The mean age at the health screening was 43.7 years. Results: After a median follow-up of 21 years, 126 men and six women (p<0.001) had large AAA that were symptomatic or evaluated for operation (5 cm diameter or more) or had autopsy-verified ruptured AAA. The male group (mean age 47 years) was, because of difference in age (p<0.001,) also compared with an age-matched control group. The male patients with AAA showed increased diastolic blood pressure (p<0.007) at the health screening. Smoking predicted the development of AAA (p<0.0001). No difference in forced vital capacity or BMI was seen. Those who were physically inactive (e.g. not walking or cycling to work) had an increased risk of developing AAA (p<0.001). Among the laboratory markers measured, the erythrocyte sedimentation rate did not differ significantly elevated in these individuals who subsequently developing AAA. The inflammatory proteins alfa-1-antitrypsin, ceruloplasmin, orosmucoid, fibrinogen, and haptoglobulin were increased (p<0.001). inactivity and cholesterol remained significant and were factors associated with the development of AAA during 21 years' follow-up. We established all risk factors, except for physical inactivity, that needs to be further verified.