What condition places a client at greatest risk for an aortic aneurysm?

Hypertension is a significant risk factor for the development of an aortic aneurysm due to the increased pressure exerted on the arterial walls over time. This sustained high blood pressure can lead to structural changes in the artery, causing it to weaken and potentially dilate, which is the fundamental process in the formation of an aneurysm. The walls of the aorta can become compromised, and the risk of a rupture increases as the aneurysm enlarges.

While hyperlipidemia (elevated levels of lipids in the blood) and atherosclerosis (the buildup of fats, cholesterol, and other substances in and on the artery walls) can contribute to cardiovascular disease and possibly influence the development of aneurysms, they do so primarily through their impact on atherosclerotic processes rather than directly causing the structural changes seen in hypertension. Diabetes mellitus can also contribute to vascular complications, but it is not as directly linked to the risk of aortic aneurysms as hypertension is. Thus, among the listed conditions, hypertension poses the greatest direct risk for the development of an aortic aneurysm.