Emphysema Might Increase Risk of Aneurysms

While the how’s and why’s of why aneurysms develop are not well understood, a recent study indicates that those with chronic obstructive pulmonary disease (COPD) are at higher risk. The study, published in the American Heart Association journal Stroke, found that the risk an aneurysm will rupture is much higher for those with COPD, and suggests that COPD may be a marker to determine if someone is at a heightened stroke risk.

Aneurysms develop on the wall of the aorta, which supplies blood to the abdomen, pelvis and legs. If one ruptures, it creates a life-threating situation. Researchers posit that the damage done by emphysema to the alveoli sacs in the lungs increase the risk for rupture. This conclusion was made after analyzing data for about 1.7 million Medicare beneficiaries over the age of 65, then following them for an additional four years. Of the more than 4,800 patients diagnosed with an aneurysm rupture, 433 had emphysema.

After accounting for other risk factors—hypertension, diabetes, tobacco use and alcohol abuse—researchers found that people with emphysema were more than twice as likely to experience a ruptured aortic aneurysm. They were also 50 percent more likely to have a subarachnoid hemorrhage caused by their aneurysm.

"We [should] tell patients with emphysema that they are at higher risk for aneurysm formation, screen them and work with them on modifiable risk factors like smoking and blood pressure control," said Dr. Ali Mahta, the study's lead author and an assistant professor of neurology in the Warren Alpert Medical School of Brown University in Providence, RI.

The study, which is the largest of its kind on the topic of aneurysm and emphysema, also suggests the two conditions may share a similar underlying pathology, accounting for their relationship, said Mahta.

The study doesn’t prove the correlation, of course, and there are limitations. For example, the study does not capture clinical variables such as severity, treatment or duration of a patient's emphysema or aneurysm, or the context in which the diagnosis was made. Even though smoking is a factor of both conditions, the data here did not show if those studies were smokers.

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