(IP031) Abdominal Aortic Aneurysm Epidemiology in United States Veterans in the Current Era

Objectives: Epidemiologic data regarding abdominal aortic aneurysms (AAAs) have been based on older studies that may not reflect current and diverse patient populations. We sought to characterize the epidemiology and risk factors for AAA in a contemporary cohort of U.S. Veterans receiving care within the Department of Veterans Affairs Healthcare System.

Methods: We analyzed data from the nationwide VA electronic health record database between 2000 and 2022, incorporating VA, fee-for-service, and Medicare records. Using multivariable logistic regression, we assessed patient characteristics associated with AAA risk. Covariates included age, sex, race, ethnicity, history of ever smoking, and history of hypertension, coronary heart disease (CHD), cerebrovascular disease (CVD), peripheral arterial disease (PAD), and type 2 diabetes mellitus (T2DM).

Results: Among 12,775,492 Veterans seeking care in the VA , 561,553 (4.4%) had clinically diagnosed AAA (Table I). The AAA cohort had a median age of 82 years (Q1-Q3: 76-88 years), was predominantly male (99%), and white (93%), with most patients (88%) reporting a smoking history. We observed a decline in new AAA cases over time, with a steeper decrease among smokers compared to non-smokers (Figure 1). Significant risk factors for AAA included age, male sex, white race, non-Hispanic or Latino ethnicity, smoking, hypertension, CHD, CVD, and PAD. Type 2 diabetes was associated with decreased risk of AAA.

Conclusions: Our findings demonstrate a consistent decrease in incident AAA cases since 2000, highlighting potential changes in disease patterns within the Veteran population; this cannot be explained solely by the decrease in the prevalence of smoking. The traditional risk factors of advanced age, male sex, and smoking remain strongly associated with AAA development.