Age, smoking, hypertension, and aortic aneurysm: Interactions and risks

Main Article Content

Seriki SA
Otoikhila OC

Abstract

Background/Aim: Aortic aneurysm is the bulging of a weakened portion of the aorta. The aorta is the major blood vessel that feeds blood (carrying oxygen, nutrients and water) to the tissues of the body. When a portion of the wall of the aorta becomes weak, blood pushing against the vessel wall can cause it to bulge like a balloon (aneurysm) leading to aortic dissection (a tear in the wall of the aorta that can cause life-threatening bleeding or sudden death). Blood pressure is the force arterial blood exerts on the wall of the artery. When this pressure is consistently high above 140/100 mmHg it is referred to as hypertension. As an individual gets older over time, physiological functions of the body depreciate leading to some abnormalities. Smoking is the consumption of tobacco mostly by inhalation of the smoke that is produced from burning the tobacco. This review article examines the close interactions between age, smoking, hypertension and aortic aneurysm, with a view to understanding mechanisms by which these factors predispose a patient to an aortic aneurism. It is also to observe if these factors interfere with treatment and recovery from aneurysms.


Conclusion: After careful review, it is observed that age and smoking are risk factors for hypertension, and together with hypertension, the three factors predispose an individual to high risk for aortic aneurysm.

Article Details

SA, S., & OC, O. (2022). Age, smoking, hypertension, and aortic aneurysm: Interactions and risks. Journal of Cardiology and Cardiovascular Medicine, 7(1), 001–005. https://doi.org/10.29328/journal.jccm.1001123
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Johnston KW, Rutherford RB, Tilson MD, Shah DM, Hollier L, et al.Suggested standards for reporting on arterial aneurysms. Subcommittee on Reporting Standards for Arterial Aneurysms, Ad Hoc Committee on Reporting Standards, Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery.J Vasc Surg.1991; 13: 452–458. PubMed: https://pubmed.ncbi.nlm.nih.gov/1999868/ DOI: https://doi.org/10.1067/mva.1991.26737

Kent KC. Abdominal Aortic Aneurysms. N Engl J Med. 2014; 371: 2101–2108. PubMed: https://pubmed.ncbi.nlm.nih.gov/25427112/ DOI: https://doi.org/10.1056/NEJMcp1401430

Upchurch GR, Schaub TA. Abdominal aortic aneurysm.Am Fam Physician. 2006; 73: 1198–1204. PubMed: https://pubmed.ncbi.nlm.nih.gov/16623206/

GBD 2013 Mortality and Causes of Death, Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.Lancet.2015; 385: 117–171. PubMed: https://pubmed.ncbi.nlm.nih.gov/25530442/ DOI: https://doi.org/10.1016/S0140-6736(14)61682-2

Abdominal Aortic Aneurysms.The Lecturio Medical Concept Library. 16 October 2020. 2021.

Vu K, Kaitoukov Y, Morin-Roy F, Kauffmann C, Tang A, et al. Rupture signs on computed tomography, treatment, and outcome of abdominal aortic aneurysms.Insights Imaging.2014; 5: 281–293. PubMed: https://pubmed.ncbi.nlm.nih.gov/24789068/ DOI: https://doi.org/10.1007/s13244-014-0327-3

Mathur A, Mohan V, Ameta D, Gaurav B, Haranahalli P. Aortic aneurysm. J Transl Inter Med.2016; 4: 35–41. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5290913/ DOI: https://doi.org/10.1515/jtim-2016-0008

Freiberg MS, Arnold AM, Newman AB, Edwards MS, Kraemer KL, et al. Abdominal aortic aneurysms, increasing infrarenal aortic diameter, and risk of total mortality and incident cardiovascular disease events. Circulation. 2008; 117: 1010-1017. PubMed: https://pubmed.ncbi.nlm.nih.gov/18268154/ DOI: https://doi.org/10.1161/CIRCULATIONAHA.107.720219

Takeuchi H, Uchida HA, Kakio Y, Okuyama Y, Okuyama M, et al. The Prevalence of Frailty and its Associated Factors in Japanese Hemodialysis Patients. Aging Dis. 2018; 9: 192–207. PubMed: https://pubmed.ncbi.nlm.nih.gov/29896410/ DOI: https://doi.org/10.14336/AD.2017.0429

Howard DPJ, Banerjee A, Fairhead JF, Handa A, Silver LE, et al. Age‐specific incidence, risk factors and outcome of acute abdominal aortic aneurysms in a defined population Br J Surg. 2015; 102: 907–915. PubMed: https://pubmed.ncbi.nlm.nih.gov/25955556/ DOI: https://doi.org/10.1002/bjs.9838

Stackelberg O, Bjorck M, Larsson SC, Orsini N, Wolk A. Fruit and vegetable consumption with risk of abdominal aortic aneurysm. Circulation. 2013; 128: 795–802. PubMed: https://pubmed.ncbi.nlm.nih.gov/23960255/ DOI: https://doi.org/10.1161/CIRCULATIONAHA.112.000728

Norman PE, Curci JA. Understanding the effects of tobacco smoke on the pathogenesis of aortic aneurysm. Arterioscler. Thromb Vasc Biol. 2013; 33: 1473–1477. PubMed: https://pubmed.ncbi.nlm.nih.gov/23685557/ DOI: https://doi.org/10.1161/ATVBAHA.112.300158

Lindholt JS, Jorgensen B, Shi GP, Henneberg EW. Relationships between activators and inhibitors of plasminogen, and the progression of small abdominal aortic aneurysms. Eur J Vasc Endovasc Surg. 2003; 25: 546–551. PubMed: https://pubmed.ncbi.nlm.nih.gov/12787697/ DOI: https://doi.org/10.1053/ejvs.2002.1872

Wilson KA, Lindholt JS, Hoskins PR, Heickendorff L, Vammen S, et al. The relationship between abdominal aortic aneurysm distensibility and serum markers of elastin and collagen metabolism. Eur J Vasc Endovasc Surg. 2001; 21: 175–178. PubMed: https://pubmed.ncbi.nlm.nih.gov/11237793/ DOI: https://doi.org/10.1053/ejvs.2001.1303

Kugo H, Zaima N, Tanaka H, Urano T, Unno N, et al. The effects of nicotine administration on the pathophysiology of rat aortic wall. Biotech. Histochem. 2017; 92: 141–148. PubMed: https://pubmed.ncbi.nlm.nih.gov/28296545/ DOI: https://doi.org/10.1080/10520295.2017.1287428

Ji K, Zhang Y, Jiang F, Qian L, Guo H, et al. Exploration of the mechanisms by which 3,4-benzopyrene promotes angiotensin II-induced abdominal aortic aneurysm formation in mice. J Vasc Surg. 2014; 59: 492–499. PubMed: https://pubmed.ncbi.nlm.nih.gov/23676189/ DOI: https://doi.org/10.1016/j.jvs.2013.03.022

Stolle K, Berges A, Lietz M, Lebrun S, Wallerath T. Cigarette smoke enhances abdominal aortic aneurysm formation in angiotensin II-treated apolipoprotein E-deficient mice. Toxicol Lett. 2010; 199: 403–409. PubMed: https://pubmed.ncbi.nlm.nih.gov/20937366/ DOI: https://doi.org/10.1016/j.toxlet.2010.10.005

Elsa K, Makoto H, Han P, Dagfinn A. Blood Pressure, hypertension and the risk of abdominal aortic aneurysms: a systemic review and meta-analysis of cohot studies. European J Epidemiol. 2019; 34: 547-555. PubMed: https://pubmed.ncbi.nlm.nih.gov/30903463/ DOI: https://doi.org/10.1007/s10654-019-00510-9

Samuel SA, Francis AO, Anthony OO. Role of the Kidneys in the Regulation of Intra- and Extra-Renal Blood Pressure. Ann Clin Hypertens. 2018; 2: 048-058. https://www.cardiologymedjournal.com/fulltext/hjch/ach-aid1011.php DOI: https://doi.org/10.29328/journal.ach.1001011

Rapsomaniki E, Timmis A, George J, Pujades-Rodriguez M, Shah AD, et al. Blood pressure and incidence of twelve cardiovascular diseases: lifetime risks, healthy life-years lost, and age-specific associations in 1.25 million people. Lancet. 2014; 383: 1899–1911. PubMed: https://pubmed.ncbi.nlm.nih.gov/24881994/ DOI: https://doi.org/10.1016/S0140-6736(14)60685-1

Ohkuma H, Suzuki S, Fujita S, Nakamura W. Role of decreased expression of the local renin-agiotensin system in the etiology of cerebral aneurysms. Circulation. 2003; 108: 785-787. PubMed: https://pubmed.ncbi.nlm.nih.gov/12912805/ DOI: https://doi.org/10.1161/01.CIR.0000087339.31094.3C

DeRubertis BG, Trocciola SM, Ryer EJ, Pieracci FM, McKinsey JF, et al. Abdominal aortic aneurysm in women: prevalence, risk factors, and implications for screening. J Vasc Surg. 2007; 46: 630–635. PubMed: https://pubmed.ncbi.nlm.nih.gov/17903646/ DOI: https://doi.org/10.1016/j.jvs.2007.06.024

Guindon GE, Boisclair D. Past, current and future trends in tobacco use: HNP discussion paper. Washington: The World Bank. 2018. http://escholarship.org/uc/item/4q57d5vp

Routine screening in the management of AAA, UK Department of Health study Report Archived. 2007.

Mortality results for randomised controlled trial of early elective surgery or ultrasonographic surveillance for small abdominal aortic aneurysms. Lancet. 352: 1649–1655. PubMed: https://pubmed.ncbi.nlm.nih.gov/9853436/ DOI: https://doi.org/10.1016/S0140-6736(98)10137-X

Bloomfield D, Carlson GL, Sapre A, Tribble D, McKenney JM, et al. Efficacy and safety of the cholesteryl ester transfer protein inhibitor anacetrapib as monotherapy and coadministered with atorvastatin in dyslipidemic patients. Am Heart J. 2009; 157: 352–360. PubMed: https://pubmed.ncbi.nlm.nih.gov/19185645/ DOI: https://doi.org/10.1016/j.ahj.2008.09.022

Torsney E, Pirianov G, Charolidi N, Shoreim A, Gaze D, et al. Elevation of Plasma High-Density Lipoproteins Inhibits Development of Experimental Abdominal Aortic Aneurysms. Arteriosclerosis, Thrombosis, and Vascular Biology. 2012; 32: 2678–2686. PubMed: https://pubmed.ncbi.nlm.nih.gov/23023368/ DOI: https://doi.org/10.1161/ATVBAHA.112.00009