AAA Screening Guidelines for Men Aged 65 and Above

Primary Screening Criteria

• The European Society of Cardiology recommends screening for men aged ≥65 years with a history of smoking to reduce risk of death from ruptured AAA, defined as lifetime smoking of >100 cigarettes or equivalent 1, 2
• Smoking is the primary indication for screening in men aged 65 years, with a Class I recommendation (strongest level) from the European Society of Cardiology 1, 2

Secondary Considerations

• Hypertension alone is not an independent indication for screening, according to the American College of Radiology, as it increases AAA risk primarily when combined with other factors like smoking, claudication, or coronary artery disease 3, 4
• The European Society of Cardiology offers a Class IIa recommendation (may be considered) for men aged ≥75 years irrespective of smoking history 2

Race Considerations

• Black race is associated with decreased risk of AAA, according to the American College of Physicians, as published in the Annals of Internal Medicine 5

Indications for Screening

• The European Society of Cardiology recommends screening for men with a first-degree relative with AAA (Class I recommendation at age ≥50 years) 1, 2
• The European Society of Cardiology also recommends screening for men with a history of smoking (primary indication) 1, 2
• Men aged ≥75 years with hypertension may be considered for screening (Class IIa recommendation) 2