Mediterranean Diet is Associated with Reduced Risk of Abdominal Aortic Aneurysm in Smokers: Results of Two Prospective Cohort Studies

Objective Smoking is a strong risk factor for the development of abdominal aortic aneurysm (AAA). It was hypothesised that Mediterranean diet via its anti-oxidative properties would decrease AAA, particularly among smokers. Methods The study population included Cohort Swedish Men (45 072 men) and Mammography (36 632 women), aged 45 – 83 years at baseline. A modified Diet (mMED) score, including eight food groups, calculated based on frequency questionnaire. Cox proportional hazard models were used to estimate ratios (HRs) with 95% confidence intervals (CIs). Results During 17.5 follow up (1 427 841 person-years), 1 781 AAA cases 496 in men, 285 women; 497 non-ruptured, 284 ruptured) ascertained registers. mMED score inversely associated incidence men (per each one point increment HR 0.96, CI 0.93 1.00) women (HR 0.83, 0.77 0.90), non-ruptured 0.95, 0.92 0.99; infrarenal diameter ≥ 30 mm 0.90, 0.81 ruptured 0.81, 0.70 0.93). In current ex-smokers low (< 20) moderate (20 39.9) pack-years smoking, statistically significant inverse association observed. HRs smokers 0.83 (95% 0.75 0.91) 0.90 0.84 0.97), respectively; 0.89 0.97) 0.85 1.01), respectively. No observed or 40 pack-years; 1.02 0.91 1.13) 0.95 1.10), Conclusion Adherence reduced smoking.