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Women smokers at higher risk of artery problems

Women who smoke are eight times more likely to have an abdominal aortic aneurysm repair or rupture than women who have never smoked, according to a new study.

Women who smoke are also four times more likely to suffer this "ballooning of the artery wall" than women who have quit smoking.

Abdominal aortic aneurysms are more common in men, but are more deadly in women — aneurysms rupture at smaller diameters in women, the rate of intervention is lower, and the number of deaths after intervention may be higher.

Professor Frank Lederle and colleagues at the VA Medical Center, Minneapolis, USA assessed potential risk factors in 161,808 postmenopausal women at 40 clinical centres in the US, in one of the first studies to look at the effect of hormone replacement therapy (HRT) on the development of abdominal aortic aneurysms in women.

There were 184 reported abdominal aneurysm events (repairs or ruptures) during the study and these were strongly linked to age and smoking. The authors report that women who had ever smoked, currently smoked and the amount smoked, all contributed to the likelihood of having an abdominal aortic aneurysm.

Interestingly, the researchers found that HRT provided protection from abdominal aortic aneurysm events despite previous smaller studies reporting that oestrogen therapy alone may increase the risk.

They also found that women with diabetes were at reduced risk of aneurysm events — a similar association has also been previously reported in men.

Increasing height, hypertension, high cholesterol, and coronary and peripheral artery disease were also associated with an increased risk of aneurysm events.

The authors conclude by calling for further research to clarify the effect of HRT on aortic aneurysm.