Prevention of Aortic Aneurysms

Aortic aneurysm rupture is a medical crisis. About 80 percent of those who experience a ruptured aortic aneurysm do not survive.

Prevention of aortic aneurysms is based on lifestyle modification. And prevention of aortic aneurysm rupture requires screening and, possibly, surgical intervention to repair the aneurysm. 

aortic aneurysm causes
Illustration by Joshua Seong. © Verywell, 2018.

Lifestyle Modification

While some risk factors for aortic aneurysms, such as gender and genetic factors, cannot be changed, most risk factors can be modified in ways that reduce your chances of developing an aneurysm of the aorta or experiencing a rupture of the aneurysm if you already have one.

An aortic aneurysm, which is a bulge in the aorta, can form due to longstanding vascular disease (blood vessel disease). Vascular disease is characterized by weakness, inflammation, and atherosclerosis (stiffening and hardening) of the blood vessels, including the aorta.

Smoking, high blood pressure, diabetes, unhealthy cholesterol levels, and inflammation all contribute to the risk of aortic aneurysm formation.

Certain lifestyle modifications can decrease your chances of developing these problems: 

  • Quit smoking: Smoking is a leading risk factor for aortic aneurysm development. If you smoke, you are at high risk of developing vascular disease. The longer you continue to smoke, the worse your vascular disease will become. Medications that reduce the severity of vascular disease are not powerful enough to counteract the effects of smoking if you continue to smoke.
  • Maintain a healthy diet: A diet that is high in trans fats, which are found commonly in processed and deep-fried food, puts you at high risk of developing vascular disease. 
  • Exercise regularly: Regular exercise reduces blood pressure, reduces inflammation, lowers the level of harmful fats in the body, and helps prevent insulin resistance.
  • Control stress: Stress is a factor that contributes to hypertension. While stress is not always a major factor in vascular disease, for some people it exacerbates the disease, causing a profoundly negative impact on health. Stress control strategies vary widely, but can be quite effective, and include reading, mindfulness, meditation, spiritual practice, socialization, and cognitive restructuring. 

If you have already had an aortic aneurysm, preventing it from rupturing is of vital importance. At-home lifestyle modifications cannot prevent an aneurysm from rupturing. The most important thing you can do to prevent an aortic aneurysm from rupturing is medical intervention.

Most aortic aneurysms do not cause symptoms, so screening and regular medical check-ups provide you with an opportunity for diagnosis at an early stage.

Medication

If you have medical conditions that predispose you to aortic aneurysms, treatment of these conditions can reduce your chances of developing an aortic aneurysm.

There are a variety of anti-hypertensive medications used to reduce high blood pressure. There are a number of factors that your healthcare provider considers when selecting the right anti-hypertensive medication for you, including your heart and kidney function.

Angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme (ACE) inhibitors—cardiac medications that affect the ability of the blood vessels to dilate (widen)—have been shown to slow potentially dangerous dilatation of the aorta. This may avert the rupture of an aortic aneurysm.

Statins, a class of medications used to lower cholesterol, also appear to reduce the growth of aortic aneurysms slightly.

Screening and Observation

An estimated 300,000 Americans have undetected aortic aneurysms, which are often small in size and may not cause any symptoms. Screening tests may be recommended based on risk factors. 

Screening Recommendations

Small aneurysms may be discovered during a physical examination or during an imaging test for another condition. The U.S. Preventative Services Task Force recommends ultrasound screening for men who are between the ages of 65 to 75 and who have any smoking history. Selective screening, which is based on an individualized medical history and physical examination, is recommended for men who have never smoked and for all women.

There are guidelines for the treatment of aneurysms. The guidelines are based on aneurysm size and location.

If you have a small aortic aneurysm, or if you have a larger aneurysm but your medical condition makes surgery a high risk, then your medical team may decide that it is best to carefully observe your aneurysm.

Your healthcare providers may schedule you for regular physical examinations to check on your symptoms and to monitor your aortic aneurysm. You may also need to have periodic ultrasounds to follow any growth or change in the shape or appearance of your aortic aneurysm and to check for leaking.

If you develop any symptoms during the time when your aortic aneurysm is being medically monitored, you should contact your healthcare provider immediately. 

Rupture Prevention

Surgical or endovascular repair of aortic aneurysms that have not ruptured is often necessary to reduce the risk of rupture. It is recommended that aneurysms in the descending aorta larger than 5 cm to 5.5 cm in diameter or that show evidence of growth, should be repaired. For the ascending aorta, the threshold is 4.5 cm for repair. This is because the larger the aneurysm, the more likely it is to rupture.

Frequently Asked Questions

  • What are the most important steps to take to avoid developing an aortic aneurysm?

    Quit smoking, maintain regular physical activity, and eat a heart-healthy diet that includes lean protein and plenty of fruits, and vegetables. Quitting smoking is especially important for preventing aortic aneurysms. Medication to lower your blood pressure may also help, though evidence for this is not conclusive. 

  • Can you prevent an aortic aneurysm from rupturing?

    There is as yet no proven way to prevent an aortic aneurysm from rupturing, other than surgery to repair the artery. Regular medical care to monitor the aneurysm’s size and growth will help you and your healthcare provider decide if or when surgery is appropriate.

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9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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