Journal of Vascular Medicine & Surgery

Abstract

Alcohol Consumption as a Risk Factor for Abdominal Aortic Aneurysm

Ben L Green, Marc A Bailey, Katherine I Bridge, Kathryn J Griffin and Julian A Scott

Introduction: Abdominal aortic aneurysm (AAA) represents a major cause of death in the over 65 age group. Current evidence suggests that AAA development may be due to an immune mediated inflammatory response leading to degradation of the extracellular matrix, increased biomechanical wall stress and resultant aortic dilatation. Modifiable risk factors include hypertension and smoking; however the potential role of alcohol remains unclear.
Methodology: The electronic databases EMBASE, Pubmed, Medline and Web of Science were searched using key word search terms in conjunction with Boolean operators based on the PRISMA recommendations (‘Ethanol’ OR ’alcohol‘) AND (“aneurysm” OR ’abdominal aortic aneurysm‘ OR ’AAA’). Articles considering an association between alcohol and patients with and without AAA were included, based on title, keyword and abstract screen. No limitation was imposed by year, methodology or language. Reference lists of included studies and pertinent journal contents were hand searched for additional suitable studies.
Results: A total of eight articles were identified for inclusion, the majority of which were retrospective and prospective cohort studies. Five of the studies reported a positive association between alcohol and AAA; however one reported a loss of association following adjustment for confounders, including smoking. Three further studies reported no association, although in two Scandinavian studies, alcohol consumption was considerably lower compared with those reporting a positive association.
Conclusion: Existing evidence is limited but may suggest a link between high levels of alcohol consumption and AAA development, whilst moderate consumption may confer some protection. Further epidemiological study is required.