To determine the prevalence of aneurysm in general population and association with lifestyle and health factors

Rupture of intracranial aneurysms (IAs) is a life threatening event, thus understanding the risk factors of aneurysm formation are crucial for developing preventive strategies. The aim of this study was to determine the association of modifiable lifestyle factors on the presence of IAs in participants who underwent whole-body MRI screening.

The study included 23,352 ( 51% males and 49% females, mean age = 51.6 ) participants who underwent whole-body MRI screenings between 2019 - 2023 at several locations across North America. Time of flight MRA sequences were evaluated for the presence of IAs. The association between lifestyle factors (smoking, alcohol consumption, BMI, hypertension) and medical history (diabetes, cardiovascular disease, past or family history of IAs) as self-reported in the intake form with the presence of IAs were examined using chi-square test and logistic regression.

A total of 484 (2%) suspected IAs were detected in our population, with 1.7% in males and 2.2% in females. Majority IAs were small, with only 7 (4%) being larger than 7mm, and 87% originated from the anterior circulation (ACA, MCA, intracranial internal carotid). Age ≥ 40 (P < .01) and individuals with hypertension ( P < .05) were more likely to have an IA. In age adjusted models, family history of IAs (OR 6.87 [95%CI, 2.19 - 21.54]), past history of IAs (OR 8.03 [95% CI, 1.76 - 36.72]), hypertension (OR 2.37 [95 % CI, 1.14 - 4.92]), elevated total cholesterol (OR 6.24 [95% CI, 1.61 - 24.09]) and cardiovascular disease (OR 6.21 [95% CI, 2.02 - 19.07]) were associated with presence of IA. 

IAs were identified in 2% of our screened population.  Preventive strategies and surveillance should be focused on high-risk individuals aged over 40, with hypertension, hypercholesterolemia, and a family or past history of aneurysm/cardiovascular disease.