Original Articles
Vol. 4 No. 2 (2025)
The role of dyslipidemia and gender-related risk factors in the management of patients with abdominal aortic aneurysms: a survey from the Italian Society of Angiology and Vascular Medicine and a call to action
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Published: 30 June 2025
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Background: abdominal aortic aneurysm (AAA) affects 1-3% of adults and carries a high fatality rate if ruptured. Although it is more common in men, women tend to have worse outcomes. Screening high-risk individuals is cost-effective, and lipid-lowering therapies (LLT) improve survival but are often underused, especially among women.
Methods: the Italian Society for Angiology and Vascular Medicine (SIAPAV) conducted a survey among healthcare professionals on AAA management, with a particular focus on lipid profile assessment, treatment, and gender differences.
Results: in a lipid management survey (64 respondents), most assessed lipid levels but rarely measured lipoprotein(a). Only 42.2% reported treating over 70% of their patients with statins, despite low rates of intolerance. A gender-specific survey (78 respondents) showed that women accounted for less than 20% of AAA patients, with limited evaluation of gynecological and obstetric histories, despite their importance as cardiovascular disease risk factors.
Conclusions: current guidelines recommend statins and LDL-C levels below 55 mg/dL for AAA patients; however, LLT remains underprescribed, particularly in women. These findings underscore the need for improved AAA management and greater attention to gender-specific risks, highlighting the importance of international collaboration.
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Citations
1. Stather PW, Sidloff DA, Rhema IA, et al. A review of current reporting of abdominal aortic aneurysm mortality and prevalence in the literature. Eur J Vasc Endovasc Surg 2014;47:240-2. DOI: https://doi.org/10.1016/j.ejvs.2013.11.007
2. Ulug P, Powell JT, Sweeting MJ, et al. Meta-analysis of the current prevalence of screen-detected abdominal aortic aneurysm in women. Br J Surg 2016;103:1097-104. DOI: https://doi.org/10.1002/bjs.10225
3. Norman PE, Powell JT. Abdominal aortic aneurysm: The prognosis in women is worse than in men. Circulation 2007;115:2865-9. DOI: https://doi.org/10.1161/CIRCULATIONAHA.106.671859
4. Moll FL, Powell JT, Fraedrich G, et al. Management of abdominal aortic aneurysms clinical practice guidelines of the European society for vascular surgery. Eur J Vasc Endovasc Surg 2011;41:S1-S58. DOI: https://doi.org/10.1016/j.ejvs.2010.09.011
5. Boudreau H, Blakeslee-Carter J, Novak Z, et al. Association of statin and antiplatelet use with survival in patients with AAA with and without concomitant atherosclerotic occlusive disease. Ann Vasc Surg 2022;83:70-9. DOI: https://doi.org/10.1016/j.avsg.2022.01.014
6. Bahia SS, Vidal-Diez A, Seshasai SRK, et al. Cardiovascular risk prevention and all-cause mortality in primary care patients with an abdominal aortic aneurysm. Br J Surg 2016;103:1626-33. DOI: https://doi.org/10.1002/bjs.10269
7. Kwan JY, Tang SH, Davies H, et al. Analyzing sex differences in intensity of cardiovascular disease prevention medications in patients with abdominal aortic aneurysms—A single-center cross-sectional study. Ann Vasc Surg 2023;90:67-76. DOI: https://doi.org/10.1016/j.avsg.2022.10.024
8. Berteotti M, Profili F, Nreu B, et al. LDL-cholesterol target levels achievement in high-risk patients: an (un)expected gender bias. Nutr Metab Cardiovasc Dis 2024;34:145-52. DOI: https://doi.org/10.1016/j.numecd.2023.09.023
9. Lampsas S, Oikonomou E, Pantelidis P, et al. Lipoprotein (a) levels and abdominal aortic aneurysm. A systematic review and meta-analysis. Curr Pharm Des 2022;28:3492-9. DOI: https://doi.org/10.2174/1381612829666221124110920
10. Duarte Lau F, Giugliano RP. Lipoprotein(a) and its significance in cardiovascular disease: A review. JAMA Cardiol 2022;7:760-9. DOI: https://doi.org/10.1001/jamacardio.2022.0987
11. Visseren FLJ, MacH F, Smulders YM, et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J 2021;42:3227-37. DOI: https://doi.org/10.1093/eurheartj/ehab484
12. Wanhainen A, Verzini F, Van Herzeele I, et al. Editor’s Choice - European Society for Vascular Surgery (ESVS) 2019 Clinical practice guidelines on the management of abdominal aorto-iliac artery aneurysms. Eur J Vasc Endovasc Surg 2019;57:8-93. DOI: https://doi.org/10.1016/j.ejvs.2020.09.004
13. Hosseini A, Sahranavard T, Reiner Ž, et al. Effect of statins on abdominal aortic aneurysm. Eur J Pharm Sci 2022;178:106284. DOI: https://doi.org/10.1016/j.ejps.2022.106284
14. Nastasi DR, Norman R, Moxon J V., et al. The potential benefits and costs of an intensified approach to low density lipoprotein cholesterol lowering in people with abdominal aortic aneurysm. Eur J Vasc Endovasc Surg 2021;62:643-50. DOI: https://doi.org/10.1016/j.ejvs.2021.06.031
15. Agarwala A, Michos ED, Samad Z, et al. The use of sex-specific factors in the assessment of women’s cardiovascular risk. Circulation 2020;141:592-9. DOI: https://doi.org/10.1161/CIRCULATIONAHA.119.043429
16. Villard C, Swedenborg J, Eriksson P, et al. Reproductive history in women with abdominal aortic aneurysms. J Vasc Surg 2011;54:341-345.e2. DOI: https://doi.org/10.1016/j.jvs.2010.12.069
17. Makrygiannis G, Courtois A, Drion P, et al. Sex differences in abdominal aortic aneurysm: The role of sex hormones. Ann Vasc Surg 2014;28:1946-58. DOI: https://doi.org/10.1016/j.avsg.2014.07.008
18. Chou EL, Pettinger M, Haring B, et al. Association of premature menopause with risk of abdominal aortic aneurysm in the women’s health initiative. Ann Surg 2022;276:e1008-16. DOI: https://doi.org/10.1097/SLA.0000000000004581
How to Cite
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Berteotti M, Ageno W, Marcucci R, Stella A, Zamboni P, Martini R. The role of dyslipidemia and gender-related risk factors in the management of patients with abdominal aortic aneurysms: a survey from the Italian Society of Angiology and Vascular Medicine and a call to action. Bleeding Thromb Vascul Biol [Internet]. 2025 Jun. 30 [cited 2025 Nov. 10];4(2). Available from: https://www.btvb.org/btvb/article/view/164
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