Abdominal aortic aneurysms in a Middle-Eastern population: Prevalence, risk factors, and implications for targeted screening

<h2>Abstract</h2><h3>Background</h3> Abdominal aortic aneurysm (AAA) is a potentially life-threatening condition that often remains undetected until rupture. Most prevalence and data concerning risk factors originate from Western countries; regional data from the Middle East are scarce. This study aimed to assess the prevalence of AAA and identify associated risk factors in a defined adult population in Saudi Arabia. <h3>Methods</h3> This prospective, single-center study was conducted in the vascular laboratory of a tertiary care center from January 2023 to January 2025. A total of 1125 patients aged ≥50 years were enrolled. All participants underwent abdominal ultrasound examination for AAA, defined as an aortic diameter of >29 mm. Demographic, clinical, and lifestyle data were collected. Statistical analyses included univariate and multivariate logistic regressions to identify predictors of AAA. <h3>Results</h3> AAA was detected in 19 participants, yielding a prevalence of 1.7%. The condition was significantly more frequent in men (2.6%) than in women (0.4%) (odds ratio [OR], 6.31; 95% confidence interval [CI], 1.45-27.45; <i>P</i> < .001). Current smokers had an AAA prevalence of 6.5%, compared with 3.0% in ex-smokers and 0.5% in nonsmokers (<i>P</i> < .001). Peripheral artery disease was independently associated with AAA (OR, 3.10; 95% CI, 1.14-8.42; <i>P</i> = .026). Statin use was inversely associated with AAA (OR, 0.36; 95% CI, 0.14-0.97; <i>P</i> = .043). No significant associations were found with hypertension, diabetes, or dyslipidemia. <h3>Conclusions</h3> AAA prevalence in this Saudi cohort was lower than in historical Western populations but comparable with recent global trends. Targeted screening of high-risk individuals, particularly older male smokers and patients with peripheral vascular disease, may be more effective than broad population screening in this region. Notably, the observed protective role of statins highlights the importance of comprehensive cardiovascular risk management.