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The Global and Regional Prevalence of Abdominal Aortic Aneurysms: A Systematic Review and Modelling Analysis.

OBJECTIVE
To estimate the global and regional prevalence and cases of abdominal aortic aneurysms (AAA) in 2019 and to evaluate major associated factors.


SUMMARY BACKGROUND DATA
Understanding the global prevalence of AAA is essential for optimizing health services and reducing mortality from reputed AAA.


METHODS
PubMed, MEDLINE and Embase were searched for articles published until Oct 11 2021. Population-based studies that reported AAA prevalence in the general population, defined AAA as an aortic diameter of 30mm or greater with ultrasonography or computed tomography. A multilevel mixed-effects meta-regression approach was used to establish the relation between age and AAA prevalence for high- socio-demographic index (H-SDI) and low-and middle-SDI (LM-SDI) countries. Odds ratios (ORs) of AAA associated factors were pooled using a random-effects method.


RESULTS
We retained 54 articles across 19 countries. The global prevalence of AAA among persons aged 30-79 years was 0.92% (95% confidence interval, CI: 0.65-1.30), translating to a total of 35.12 million (95% CI: 24.94-49.80) AAA cases in 2019. Smoking, male sex, family history of AAA, advanced age, hypertension, hypercholesterolemia, obesity, cardiovascular disease, cerebrovascular disease, claudication, peripheral artery disease, pulmonary disease and renal disease were associated with AAA. In 2019, the Western Pacific region (WPR) had the highest AAA prevalence at 1.31% (95% CI: 0.94-1.85), while the African region (AFR) had the lowest prevalence at 0.33% (95% CI: 0.23-0.48).


CONCLUSIONS
A substantial proportion of people are affected by AAA. There is a need to optimise epidemiological studies to promptly respond to at-risk and identified cases to improve outcomes.