Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Aortic Disease
Multicenter Investigations of the Prevalence of Abdominal Aortic Aneurysm in Elderly Japanese Patients With Hypertension
– The AAA Japan Study –
Shota FukudaHiroyuki WatanabeKatsuomi IwakuraMasao DaimonHiroshi ItoJunichi Yoshikawafor the AAA Japan Study Investigators
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Supplementary material

2015 Volume 79 Issue 3 Pages 524-529

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Abstract

Background:Physical examination as an initial screening tool to diagnose abdominal aortic aneurysm (AAA) has lost favor over the past 20 years. This multicenter cohort study aimed to determine the prevalence of AAA in elderly Japanese patients with hypertension (HT) and to clarify the diagnostic accuracy of physical examination using a pocket-sized ultrasound imaging device (the “pocket-echo”).Methods and Results:A total of 1,731 patients with HT aged >60 years from 20 collaborating institutions were enrolled in this study. Abdominal palpation was performed on physical examination, and the pocket-echo was used to confirm the diagnosis of AAA. The abdominal aorta was well visualized in 1,692 patients (98%). AAA was discovered in 69 patients (4.1%), with advanced age and male sex identified as independent risk factors. The prevalence of AAA increased according to age regardless of sex, and reached 9.2% and 5.7%, respectively, in males and females ≥80 years. Overall, 33 cases of AAA were missed on abdominal palpation (sensitivity, 52%), whereas for AAAs >40 mm, the sensitivity was 75%.Conclusions:We assessed the utility of the pocket-echo and physical examination for diagnosing AAA in Japanese patients with HT aged over 60 years. Our findings highlight the importance of AAA screening programs in high-risk Japanese populations, and confirm the ability of physical examination to detect large, but not small, AAAs. (Circ J 2015; 79: 524–529)

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© 2015 THE JAPANESE CIRCULATION SOCIETY
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