While it is important to recognize all factors that increase cardiovascular disease, a family history of a first-degree relative with an AAA has been shown to be highly predictive. Eighteen percent of patients with an AAA have a first-degree relative who also had an AAA. Diabetes mellitus, hypertension, high cholesterol, and smoking may all be associated with the development of an AAA or cardiovascular disease in general but not as much as a strong family history.