If you smoke, you’re twice as likely to develop an abdominal aortic aneurysm, according to a study released Thursday.

An abdominal aortic aneurysm is a bulge in the large artery that supplies blood to the belly, pelvis and legs. The bulging occurs without symptoms, unless the artery ruptures. If that happens, severe internal bleeding creates an urgent medical situation.

“Our study quantified the lifetime risk of an abdominal aortic aneurysm and found that it was far from trivial for smokers,” said Weihong Tang, Ph.D., M.S., M.D., lead study author and associate professor of epidemiology and community health at the University of Minnesota. “And we quantified the benefit of quitting smoking, which turns out to be substantial.”

Researchers looked at 15,792 people over age 45 enrolled in the national Atherosclerosis Risk in Communities Study. After 22 years of follow-up, researchers identified 590 cases of a ruptured, surgically repaired or clinically diagnosed asymptomatic abdominal aortic aneurysm and 75 cases of asymptomatic aneurysms detected by an ultrasound screening.

Researchers found the lifetime risk of an abdominal aortic aneurysm were:

  • One in 17 among all study participants
  • One in nine among current smokers
  • One in nine among those in the top third of smoking pack-years (number of cigarettes smoked over a lifetime), whether a current or former smoker
  • One in 12 among current female smokers

Researchers also found those who had quit smoking for 3-8 years (recent quitters) still had an approximately 2.6 to 3.5 fold increased risk for clinical and asymptomatic abdominal aortic aneurysm in the next 15 years compared to never smokers. Their lifetime risk was 6.6 percent higher than long-term quitters.

The United States Preventive Services Task Force recommends that current or former male smokers undergo an ultrasound screening for an abdominal aortic aneurysm once between ages 65-75, but makes no recommendation for women.

“Women who currently smoke have a similar risk as men who quit smoking, and yet the task force does not recommend screening these women,” Tang said. “This is important data that physicians and health policy makers should be aware of.”

The study also found that being older, white or having high levels of bad cholesterol also increased the risk of abdominal aortic aneurysm.

“The strongest associations, however, remain with smoking,” Tang said. “And the best preventive strategy to reduce abdominal aortic aneurysms in smokers is to stop smoking.”

The study is published in the American Heart Association journal Arteriosclerosis, Thrombosis and Vascular Biology.