Smoking may perk up women's risk of developing deadly AAA

Washington, United States, October 17: A new research has found that women who smoke are at significantly increased risk of developing an abdominal aortic aneurysm, a condition in which a weak area of the abdominal aortadefine expands or bulges.

Abdominal aortic aneurysm, also written as AAA and often pronounced 'triple-A', is caused by a weakened area in the main vessel that supplies blood from the heart to the rest of the body, according to the Society of International Radiology website. When blood flows through the aortadefine, the pressure of the blood beats against the weakened wall, which then bulges like a balloon. If the balloon grows large enough, there is a danger that it will burst. And, if the aneurysm ruptures, most patients die before reaching a hospital.

The risk of AAA becomes greater with age and is more common in men than women and more common in smokers or former smokers. Though the condition is more common in men, it is more deadly in women. In the United States, ruptured AAA is the 10th leading cause of death in men over age 55, with 80 to 90 percent of all ruptured aneurysms resulting in death.

Now, a novel study published on Tuesday by the British Medical Journal has suggested that women who smoke are more likely to undergo surgery for an abdominal aortic aneurysm (AAA) or to experience a ruptured aneurysm than their ex-smoking and non-smoking peers.

The largest study of its kind, conducted by Professor Frank Lederle and colleagues, warns that female smokers are eight times more likely to have an abdominal aortic aneurysm repair or rupture than women who have never smoked, and are four times more likely than women who have quit smoking.

To reach their findings, Prof. Lederle and colleagues assessed the potential risk factors for the rupture and repair of AAA in 161,808 postmenopausal women at 40 clinical centres in the United States. The study women were part of the Women’s Health Initiative.

After following for an average of 7.8 years, the researchers found 184 abdominal aneurysm events (repairs or ruptures), which all were strongly linked to age and smoking.

Prof. Lederle’s team found that women who had never used tobacco, currently smoked and the amount smoked, all contributed to the possibility of having an abdominal aortic aneurysm.

Further, it was found that current smokers had an increased risk of an AAA event by 5-fold compared to former smokers, and 9-fold compared to those who never took up the habit. In addition, for every 10-year increase in age, the risk of an AAA event increased by 77 percent, while diabetes decreased the risk of condition by 71 percent.

Interestingly, the researchers found that women on hormone replacement therapy (HRT) had a lower risk of developing aneurysm condition.

Although HRT cut the odds of an AAA event in the study, the researchers of the latest study say more studies are required to determine the role of the therapy in preventing the condition in women.

"We're certainly not advising anyone to take hormone replacement therapy for this purpose, because we have large randomized trials in the Women's Health Initiative that show it's not beneficial across the full range of important [health] effects," he said.

"What we're saying is that, curiously, it seems in this study to be protective of this one disease, and so that should guide future laboratory research, maybe drug development, but absolutely should not be a recommendation to treat with hormone replacement therapy to prevent aortic aneurysm."