Is Depression Linked to Abdominal Aortic Aneurysm Progression?

No correlation was observed between symptoms of depression and progression of an abdominal aortic aneurysm (AAA) during a retrospective cohort study, the results of which were published in the Annals of Vascular Surgery.

Data were sourced from an AAA surveillance study conducted between 2003 and 2018 at 4 outpatient vascular centers in Australia. Patients (N=574) with AAA were assessed for symptoms of depression. AAA progression was measured by ultrasound surveillance a median of 3 (interquartile range [IQR], 2-5) times over a median follow-up period of 2.1 (IQR, 1.1-3.5) years.

A total of 12.7% of patients were diagnosed with depression. The depression and no depression cohorts had a median age of 72.6 (IQR, 69.0-78.4) and 74.6 (IQR, 69.3-79.9) years, respectively. The depression and no depression cohorts were 77.5% and 82.2% male, respectively.

Compared between cohorts, a diagnosis of depression did not have an effect on AAA progression before or after adjusting for potential covariates (adjusted mean difference, -0.3; 95% CI, -0.8 to 0.2 mm/year; P =.27).

A similar pattern for the relationship between depression and AAA progression was observed among a propensity-matched subset (adjusted mean difference, 0.7; 95% CI, -0.8 to 2.2 mm/year; P =.37).

AAA growth was associated with initial AAA size in tertile 3 (estimate, 12.0; 95% CI, 5.7-6.6; P <.001), size in tertile 2 (estimate, 6.1; 95% CI, 5.7-6.6; P <.001), and time (estimate, 1.6; 95% CI, 1.4-1.7; P <.001).

Stratified by depression, individuals with depression were predicted to progress from an AAA of 39.2 mm to 42.5 mm at 2.5 years and individuals without depression from 39.7 mm to 43.6 mm.

This study may have been limited by the small sample sizes overall and among the subset of individuals with diagnosed depression.

There was little evidence to suggest that a depression comorbidity effected AAA progression.


Thanigaimani S, Phie J, Quigley F, et al. Association of diagnosis of depression and small abdominal aortic aneurysm growth. Ann Vasc Surg. 2021;S0890-5096(21)00610-5. doi:10.1016/j.avsg.2021.06.038