Sudden ruptures often end in death. The muscular wall of the aorta weakens and begins to bulge. High blood pressure may speed up the weakening, but it is not the cause. A genetic factor may be involved because aneurysms tend to run in families. There is a strong relationship between AAA and cigarette smoking.
Smokers die from ruptured aneurysms four times more often than nonsmokers.
Aneurysms in smokers expand and weaken faster than do those in nonsmokers. AAA may not cause symptoms for a long time. There may be an occasional mild abdominal ache, back pain, or groin pain, but most people have very few complaints. Sudden, very severe abdominal or back pain may suggest rupture of the aorta. When that happens you need immediate medical attention.