Who gets aneurysms and how can they be prevented?
Who gets aortic aneurysms?
Abdominal aortic aneurysms usually occur in men aged over 65. Occasionally they occur and cause problems in men in their 50s but almost never at a younger age. They are about five times less common in women.
Studies that have scanned large numbers of men aged 65 or over show that the aorta is wider than normal in around 5 per cent (1 man in 20) but most of these small aneurysms never grow to a large size and never need treatment.
Aortic and other aneurysms are very rarely caused by infection or trauma, but over 99 per cent arise with no obvious cause.
Familial aortic aneurysms
Aortic aneurysms certainly do tend to ‘run in families’. If you have a first-degree relative (parent, brother or sister) with an aneurysm, then your chance of developing one is about ten times higher than normal.
A lot of research has been done to try to identify one or more genes that might be responsible for causing aneurysms. In addition, members of families are often exposed to the same risks as each other – for example, by smoking and eating similar diets.
Smoking, high blood pressure and raised cholesterol
All these are definite risk factors for developing an aortic aneurysm. Smoking is the most important, increasing the risk of you developing an aneurysm fivefold.
Preventing aneurysms from causing trouble
Increasingly, doctors are advising people with aortic aneurysms to take the same kind of precautions as they would advise for atherosclerosis (narrowing of the arteries). This is partly because the two conditions often occur together, but also because there is increasing evidence that these measures might help to slow the growth rate of aneurysms and reduce the risk of them leaking. These measures are as follows.
Stop smoking
The most important thing that you can do is stop smoking. There are many ways that people can be helped with this, including the use of nicotine replacement therapy, counselling and medicines (for example, buproprion).
Treatment with statins to reduce cholesterol
This seems to be beneficial for people with diseased arteries even if their cholesterol is not abnormally high.
Treatment of high blood pressure
Untreated or inadequately treated high blood pressure is associated with the enlargement of aortic aneurysms and may increase the risk of rupture.
Low-dose aspirin treatment
This may reduce the build-up of thrombus (blood clot) within aortic aneurysms and is commonly advised, but any benefit for the growth of aneurysms or the risk of them leaking has not been proved.
Experimental treatments
A number of different kinds of medicines have been studied for their possible effect in reducing the growth rate of aortic aneurysms, or even the possibility of preventing aneurysms from developing in people at risk (for example, people with aortic aneurysms in their family). These include the following medications.
Propranolol
This is a medicine used in the treatment of high blood pressure and heart problems. It was shown to have some effect in slowing the growth rate of aneurysms, but caused side effects that made many patients stop taking it.
Antibiotics
Antibiotics such as tetracyclines have been tested in small studies.
Various experimental medicines have been used in studies on animals.
