Which lifestyle choice is considered the primary risk factor for developing AAA?

Smoking is recognized as the primary risk factor for developing abdominal aortic aneurysm (AAA). Research has shown that tobacco use significantly contributes to the weakening of the arterial walls, leading to an increased likelihood of aneurysm formation. The toxins in cigarette smoke can promote inflammation, oxidative stress, and the degradation of the structural components of blood vessels, particularly elastin and collagen, which are critical for maintaining vascular integrity.

While other lifestyle choices, such as obesity, high cholesterol, and excessive alcohol consumption, can contribute to cardiovascular diseases and may elevate the risk of aneurysm indirectly, they are not considered the primary risk factors for AAA as smoking is. For instance, obesity can influence the development of atherosclerosis and other related conditions, but it does not have the direct impact on the structural integrity of blood vessels that smoking does. Similarly, high cholesterol primarily contributes to plaque buildup rather than directly affecting the aorta's ability to withstand pressure. Excessive alcohol consumption may lead to hypertension and other cardiovascular issues, but it does not have the same well-established association with AAA as smoking. Therefore, smoking stands out as the most significant and direct lifestyle choice linked to the risk of developing an abdominal aortic aneurysm.