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Senior Citizen Health & Medicine
Abdominal Aortic Aneurysm is Big Killer of Older Men
and Drawing New Attention
Race
against the clock as Medicare approves screening for rapidly aging
population
June 23, 2006 It is a condition many older men
may not have even heard of, but it is at least the 10th leading killer
in the U.S. and primarily affects men over age 55. Now, with the aging
of the baby boomers and the mushrooming of the number of older men,
abdominal aortic aneurysm (AAA) is getting more attention, including a
new screening procedure approved by Medicare that may soon tell many men
that they have a killer condition that they can do little or nothing
about.
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"Many people don't even make it to the
hospital, and those who do often die of complications."
Society of Vascular Surgery
Read more below news story. |
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Anticipating a surge in diagnosed cases of
abdominal aortic aneurysm, a condition for which Medicare just approved
a one-time free screening for men, University of Kentucky researchers
are working with $8.5 million in National Institutes of Health (NIH)
funding to understand the condition and how it can be treated.
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Medicare Campaign to Emphasize Preventive Care
'90%-plus of what we are spending is going for
the complications of chronic disease'
June 19, 2006 The Centers for Medicare & Medicaid
Services is planning a campaign for the summer to encourage greater use
of preventive services available through Medicare with a special effort
to reach minorities. To add to this national emphasis on preventive
care, the American Medical Association has just elected its first
president with a board certification in preventive medicine.
Read more...
Read more
on
Health & Medicine |
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"In collaborative studies with Lisa Cassis,
professor and director of the UK Graduate Center for Nutritional
Sciences, we serendipitously developed an animal model of abdominal
aneurysms that is not used in many laboratories, This model has provided
us with way of defining the mechanisms that initiate and propagate this
devastating disease," said Alan Daugherty, Director, UK Cardiovascular
Research Center.
In the United States there are currently 78.8
million baby boomers people born between 1946 and 1964. More than half
of baby boomers will be age 50 or older by next May, and this January
will mark the 60th birthdays of the oldest boomers, according to an
analysis of U.S. Census data by American Demographics.
Abdominal aneurysm currently ranks as the 10th
leading killer in the United States; although scientists suspect that
the incidence may be even higher as the disease is only detected upon
autopsy, and autopsies are not always performed in the deaths of older
people.
The condition primarily affects men over age 55, so
the Medicare-covered screening will only be for men.
Currently, if a screening detects an abdominal
aneurysm, patients face an expensive and unsure course of surgical of
treatment. The aneurysm must be monitored, and physicians must use their
best judgment to decide when and if surgery is warranted.
Open surgery is a long term fix for this disease,
but is associated with risks and long recovery times. More recently,
endovascular approaches have been developed in which patients recover
quickly. However, this intervention is not without significant risk, and
is expensive. There is a dire need for development of a drug that will
favorably impact this disease.
At present, there is no non-surgical therapy for
abdominal aortic aneurysm that has proven of benefit.
The expected hit to the Medicare system from the
influx of aging baby boomers means that surgical treatment for every
case of abdominal aneurysm expected to be diagnosed in coming years
would be prohibitive.
Aside from costs, the number of surgeons, support
staff and facilities equipped to deal with the surgery will be
outstripped by the need to treat the huge numbers of men who may learn
they have an aneurysm threatening their lives.
The research team at UK HealthCare's Jack and Linda
Gill Heart Institute, led by Daugherty, will spend the next five years
working with an animal model of abdominal aneurysm. The goal is to form
a sufficient understanding of the condition to move into clinical
trials, and eventually into the implementation of a pharmacological
treatment for abdominal aneurysm.
Cassis and Nancy R. Webb, associate professor of
internal medicine, along with Daugherty will direct their research
toward understanding three separate facets of abdominal aneurysm. Cassis
will lead a group focusing on gender effects, asking why the condition
is much more prevalent in men.
Webb's team will look at the role inflammation
processes play in the disease, while Daugherty will investigate why
abdominal aneurysm is always located in a specific location of the
abdominal aorta.
A pharmacological solution to abdominal aneurysm
treatment would mean that instead of waiting and wondering about a
diagnosed aneurysm, patients and their doctors could aggressively treat
the problem through drug therapies.
Pharmacological treatment is projected to be less
expensive and less risky for most patients. Given the amount of time it
takes to research a drug and bring it to market, it is possible that
today's crop of 50-something baby boomer men may have an answer to
abdominal aneurysm treatment by the time they qualify for the
Medicare-approved screening at age 65.
UK was chosen as the site for this research after a
peer review process at the National Institutes of Health
enthusiastically endorsed the proposed research program that has been
developed by the team of UK investigators, Daugherty, Cassis, and Webb.
The Cardiovascular Research Center currently has more than $20 million
dollars in NIH and other funding, and is a leader in cutting-edge
clinical and translational research.
About University of Kentucky
In striving to become a Top 20 public research
institution, the University of Kentucky is a catalyst for a new
Commonwealth a Kentucky that is healthier, better educated, and
positioned to compete in a global and changing economy. For more
information about UK's efforts to become a Top 20 university, please go
to
http://www.uky.edu/OPBPA/Top20.html
More About Abdominal Aortic Aneurysms
By the Society of Vascular Surgery
Aneurysms occur most often in the
aorta, the main artery of the chest and abdomen. The aorta carries blood
flow from the heart to all the vital organs and eventually to the legs
and feet. Abdominal aortic aneurysms (AAA) are caused by a progressive
weakening of the aortic wall that causes a dilation, or ballooning of
the vessel. The aneurysm will grow larger and eventually rupture if it
is not diagnosed and treated.
When an aortic aneurysm ruptures it is an
emergency!
● Many people don't even make it to the hospital,
and those who do often die of complications.
● Ruptured aortic aneurysm is the 13th leading cause of death in the
US.
● More than 15,000 Americans die each year due to ruptured aneurysms,
many of them needlessly!
That's why we say, "It's a matter of life and
limb!"
When aortic aneurysms are diagnosed early,
treatment is safe and effective and the aneurysm is cured! AAA can be
diagnosed by a simple ultrasound scan that can be performed in a few
minutes without risk or discomfort.
Surgery is usually required to repair an AAA, but
modern, catheter-based technologies using endovascular grafts have made
treatment less invasive in many cases. The combination of early
diagnosis and modern treatment of aortic aneurysms can save countless
lives lost due to aneurysm rupture each year.
Major risk factors for abdominal aortic aneurysms
● Age over 60 years
● A family history of AAA
● Smoking
● High blood pressure
The risk of AAA increase with age and aneurysm are
much more common in men than in women. A family history of AAA is
particularly concerning, so if any of your relatives had an aneurysm,
tell your doctor arrange a screening exam!
Cause of Aortic Aneurysms
Most aneurysms are caused by a breakdown in the proteins that provide
the structural strength to the wall of the aorta, the body's main
artery. These proteins, called collagen and elastin can gradually
deteriorate with age, but inflammation that is associated with
atherosclerosis can accelerate this process even in younger people.
There are also naturally occurring enzymes that
cause the breakdown of collagen and elastin. An excess of these enzymes
or other conditions that activate these enzymes may also contribute to
the formation of an aneurysm, or its sudden growth.
In rare cases an aneurysm may be caused by
infection. There is still much to be learned about the cause of
aneurysms and their growth, but fortunately we have successful,
permanent treatments for AAA when they occur.
Vascular surgeons have performed much of the basic
research on aneurysm formation.
>>
Read more from the Society for Vascular Surgery
>>
Read about Medicare Preventive Care
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