Evidence map›Paper›PMID 41713390›Full record

ArticleAtherosclerosis2026

Sex-based differences in cardiovascular risk management and abdominal aortic aneurysm growth: Insights from a contemporary cohort study.

Fahad Alkhalfan, Essa Hariri, Anu Aggarwal, Pulkit Chaudhury, Natalia Fendrikova Mahlay, Robert Burton, A Phillip Owens, Scott J Cameron

Abstract readComparative Study
In one paragraph

Article in Atherosclerosis, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Fahad AlkhalfanSection of Vascular Medicine, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, OH, USA; Heart, Blood, and Kidney Research, Cleveland Clinic Research, Cleveland, OH, USA.
Essa HaririDivision of Cardiology, Johns Hopkins Medicine, Baltimore, MD, USA.
Anu AggarwalHeart, Blood, and Kidney Research, Cleveland Clinic Research, Cleveland, OH, USA.
Pulkit ChaudhurySection of Vascular Medicine, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
Natalia Fendrikova MahlaySection of Vascular Medicine, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
Robert BurtonDepartment of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA.
A Phillip OwensDepartment of Internal Medicine, Division of Cardiovascular Health and Disease, University of Cincinnati, OH, USA.
Scott J CameronSection of Vascular Medicine, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, OH, USA; Heart, Blood, and Kidney Research, Cleveland Clinic Research, Cleveland, OH, USA; Department of Hematology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, OH, USA. Electronic address: cameros3@ccf.org.

Funding

Role of the Gut Microbiota in Abdominal Aortic AneurysmR01HL147171 · NHLBI · UNIVERSITY OF CINCINNATI · PI OWENS III, ALBERT PHILLIP · 2020 to 2023
$2.5M
Platelets as Biosensors and Mediators of Aortic Aneurysm GrowthR01HL158801 · NHLBI · CLEVELAND CLINIC LERNER COM-CWRU · PI CAMERON, SCOTT JAMES · 2021 to 2025
$2.5M
Platelets as therapeutic and diagnostic entity in fibromuscular dysplasiaK99HL181079 · NHLBI · CLEVELAND CLINIC LERNER COM-CWRU · PI Anu Aggarwal · 2025 to 2026
$238k
NHLBI NIH HHS K99 HL181079NHLBI NIH HHS R01 HL147171NHLBI NIH HHS R01 HL158801
6 · The paper itself

Abstract

introductionAlthough abdominal aortic aneurysms (AAA) are more prevalent in men, women experience more unpredictable AAA growth and rupture risk, and higher mortality. This study aimed to compare sex differences in cardiovascular risk reducing strategies and AAA outcomes.

methodsAnnualized AAA growth rates and outcomes were assessed over a 10-year period in patients with at least two aortic duplex studies. We compared baseline demographics and prescribing patterns between men and women. Variables associated with fast AAA growth (≥0.5 cm/year) were identified using backward selection, and analyses were stratified by sex.

resultsOf the 2008 patients included in this analysis, 20.0% were women. Women had higher systolic blood pressures, higher rates of smoking, and were less likely to be prescribed Statins or angiotensin converting enzyme inhibitors/angiotensin receptor blockers (ACEi/ARBs). No significant difference was observed between men and women in the rates of rapid growth, dissection, rupture, repair, or all-cause mortality. While there were no sex-specific differences in the variables included in our final model (aspirin, metformin, coronary artery disease, smoking, and hypertension), ACEi/ARBs were associated with lower odds of fast AAA growth in women but not men, indicating a sex-specific interaction.

conclusionWhile we did not identify differences in AAA outcomes, our findings reveal a disparity in the application of cardiovascular risk reducing strategies between men and women. The observed association between ACEi/ARB use and slower growth in women, but not in men, warrants further investigation. These results underscore the need for more targeted and equitable cardiovascular risk management.

Indexed as

Aortic Aneurysm, AbdominalCardiovascular DiseasesAgedAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsAortic RuptureDisease ProgressionFemaleHeart Disease Risk FactorsHumansMaleMiddle AgedRisk FactorsSex FactorsSmokingTime FactorsAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsAbdominal aortic aneurysmAtherosclerosisSex

Identifiers

PMID41713390
PMCPMC13063149

What Socratic holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.