Baseline prevalence of abdominal aortic aneurysm, peripheral arterial disease and hypertension in men aged 65-74 years from a population screening study (VIVA trial)

Background: Abdominal aortic aneurysm (AAA) screening has been introduced into some health systems and could easily be supplemented with broader vascular screening. The aim of this study was to evaluate the screening set-up and investigate combined screening for AAA, peripheral arterial disease (PAD) and possible hypertension (HT), and detection rates. Methods: This observational study was based on the intervention arm of a screening trial in 25083 Danish men aged 65-74 years. A combined screening programme for AAA, PAD and HT was offered at local hospitals. Participants with positive test results were offered secondary prophylaxis and/or referred to their general practitioner. The programme set-up included decentralized screening by three mobile teams at 14 venues. Diagnostic criteria were: aortic diameter at least 30mm for AAA, ankle:brachial pressure index below 09 or above 14 for PAD, and BP exceeding 160/100 mmHg for HT. Results: Overall, 18749 men (uptake 747 per cent) attended the screening. An AAA was diagnosed in 33 (95 per cent c.i. 30 to 36) per cent, PAD in 109 (105 to 114) per cent and HT in 105 (100 to 109) per cent. Lipid-lowering and/or antiplatelet treatment was initiated in 348 per cent of the participants. Conclusion: Preventive actions were started in one-third of the attenders. The long-term effect of this on morbidity and mortality is an important part of future analysis. The trial confirms that the prevalence of AAA in Denmark has decreased only slightly in the past decade, from 40 to 33 per cent, in contrast to other nations.