Patient c/o severe tearing lower back pain radiates to the flank, nausea, and vomitings. He has hypertension and hyperlipidemia and h/o coronary artery bypass grafting of his right coronary artery. 2 years back. Chronic smoker and alcoholic. There is a pulsatile mass in the abdomen. Which of the following was the strongest predisposing factor for this patient's underlying condition?