A HEALTH screening programme in Herefordshire and Worcestershire is proving a huge success in helping to identify men aged 65 and over with a possible life-threatening abdominal aortic aneurysm (AAA).

The AAA screening programme in the two counties saw a 84.2 per cent uptake from men offered screening in 2014-15, making it the fifth highest uptake in the country and higher than the national average, which stands at 79.5 per cent.

The national programme aims to reduce the number of deaths from AAA rupture through early detection, appropriate monitoring and treatment.

An AAA is caused when the main blood vessel in the body weakens and expands. Most people have no symptoms but, if left untreated, aneurysms can grow and rupture. This can cause massive internal bleeding, which is usually fatal.

Eight out of every 10 people with a ruptured AAA die before they reach hospital or fail to survive emergency surgery.

This swelling is far more common in men aged over 65 than it is in women and younger men, so men are invited for screening in the year they turn 65.

The screening involves a simple ultrasound scan that looks for a weakness and enlargement of the aorta, the main blood vessel in the body and the results are available straight away.

Catherine Schorah, screening co-ordinator at Hereford and Worcester AAA Screening Programme, said: “The programme has been a major public health success story, locally as well as nationally.

“Our programme is crucial in detecting and treating large aneurysms, in the region’s men, leading to the prevention of premature deaths in local men aged 65 years and over.

“The fact that 4,100 eligible men in Herefordshire and Worcestershire have taken up their invitation for AAA screening in 2014 to 2015, shows how successful we are in engaging with the local population.

“It is important that all eligible men make an informed choice when deciding whether or not to be screened for AAA.”

Dr Carl Ellson, Chief Clinical Officer for NHS South Worcestershire CCG, said: “It’s important that all eligible men take up the opportunity to be screened for an abdominal aortic aneurysm. If left untreated, aneurysms can grow and rupture, which can be fatal.

“Abdominal aortic aneurysms are most likely to develop in men over the age of 65, with smokers, people with high blood pressure and anyone with a family history of the condition at most risk.”

The screening programme has been running in Herefordshire and Worcestershire since 2011 and any men who were over 65 when it started or could not attend their ultrasound scan appointment are urged to self-refer so they can be checked for an AAA which, if detected, can be monitored or treated if necessary – therefore preventing premature death.

The possible screening results include:

• Normal (aorta less than 3cm in diameter): Man discharged from screening programme

• Small aneurysm (3 to 4.4cm): Man invited back for screening in 12 months

• Medium aneurysm (4.5 to 5.4cm): Man invited back for screening in 3 months

• Large aneurysm (5.5cm+): Man referred to vascular surgeon to discuss treatment options, usually surgery

Anyone who declines the screening offer can change their mind at a later date and also self-refer. Screening takes place at around 60 locations in Herefordshire and Worcestershire including GP practices, community hospitals and acute trust hospitals.

Anyone wanting to self-refer to be scanned for an AAA should ring the screening programme office at Worcestershire Royal Hospital on 01905 733830.

Well over 10,000 aneurysms have been detected that need monitoring or treatment since the national programme began in 2009 and more than 2,000 men with large aneurysms have been referred for successful surgical repairs - including several in the West Midlands region.

According to the NHS, in most cases an AAA causes no noticeable symptoms. However, if it becomes large, some people may develop a pain or a pulsating feeling in their abdomen (tummy) or persistent back pain.

An AAA doesn’t usually pose a serious threat to health, but there is a risk that a larger aneurysm could burst. The most common symptom of a ruptured aortic aneurysm is sudden and severe pain in the abdomen. Other symptoms include dizziness; sweaty and clammy skin; rapid heartbeat (tachycardia); shortness of breath; feeling faint; loss of consciousness.

If anyone suspects they or anyone else has had a ruptured aneurysm, they should call 999 immediately and ask for an ambulance.

• An aneurysm is a bulge in a blood vessel caused by a weakness in the blood vessel wall. As blood passes through the weakened blood vessel, the blood pressure causes it to bulge outwards.

• Exactly what causes the blood vessel wall to weaken is unclear, though hardening of the arteries, smoking and high blood pressure are thought to increase the risk of an aneurysm. Increasing age and being male are known to be the biggest risk factors. One study has found that people aged over 75 are seven times more likely to be diagnosed with an AAA than people under 55 years old. Men are around six times more likely to be diagnosed with an AAA than women.

• Research has found that smokers are seven times more likely to develop an AAA than people who have never smoked and the more they smoke, the greater the risk of developing an AAA. People who regularly smoke more than 20 cigarettes a day may have more than 10 times the risk of non-smokers. The risk may increase because tobacco smoke contains harmful substances that can damage and weaken the wall of the aorta.

• Atherosclerosis - a potentially serious condition where arteries become clogged up by fatty deposits such as cholesterol – is also thought to contribute to the risk of an AAA because these deposits (called plaques) cause the aorta to widen in an attempt to keep blood flowing through it. As it widens, it also gets weaker. Smoking, eating a high-fat diet and high blood pressure all increase your risk of developing atherosclerosis. High blood pressure (hypertension) can also place increased pressure on the aorta's wall.

• People with a family history of AAAs means they have an increased risk of developing one. One study found that people who had a brother or sister with an AAA were eight times more likely to develop one than people whose siblings were unaffected.

• Aneurysms can occur anywhere in the body, but the two most common places for them to form are in the abdominal aorta and the brain.

1. aorta

2. heart

3. aortic aneurysm

4. aorta leading away from the heart

5. kidney