Abdominal aortic aneurysm medical therapy: Difference between revisions
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==Overview== | ==Overview== | ||
Risk factor modification including [[smoking cessation]], management of [[hypertension]], and [[lipid lowering]] are essential in reducing the risk of development and the rate of progression of abdominal aortic aneurysms. | Risk factor modification including [[smoking cessation]], management of [[hypertension]], and [[lipid lowering]] are essential in reducing the risk of development and the rate of progression of abdominal aortic aneurysms. | ||
==Risk Factor Modification== | |||
* [[Smoking]] contributes to formation and rupture of aneurysm and smoking cessation should be encouraged in patients with an abdominal aortic aneurysm and in individuals with family history of abdominal aortic aneurysm | |||
*Risk factors for [[atherosclerosis]] development and progression such as [[hypertension]] and [[hyperlipidemia]] should be controlled | |||
==Medical Therapy== | ==Medical Therapy== | ||
=== | ===[[ACEI]]=== | ||
*These agents may be administered to control hypertension in patients with | |||
===[[Statins]]=== | |||
* | * May reduce mortality in patients who have undergone an abdominal aortic aneurysm repair <ref name="pmid16414398">{{cite journal |author=Kalyanasundaram A, Elmore JR, Manazer JR, ''et al.'' |title=Simvastatin suppresses experimental aortic aneurysm expansion |journal=[[Journal of Vascular Surgery]] |volume=43 |issue=1 |pages=117–24 |year=2006 |month=January |pmid=16414398 |doi=10.1016/j.jvs.2005.08.007 |url=}}</ref> | ||
===[[Beta blockers]]=== | |||
* May have a beneficial effect on expansion of aneurysm from its effect on reduction of [[blood pressure]]. It is used routinely in patients with abdominal aortic aneurysm followed non-operatively <ref name="pmid16549646">{{cite journal |author=Hirsch AT, Haskal ZJ, Hertzer NR, ''et al.'' |title=ACC/AHA 2005 Practice Guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation |journal=[[Circulation]] |volume=113 |issue=11 |pages=e463–654 |year=2006 |month=March |pmid=16549646 |doi=10.1161/CIRCULATIONAHA.106.174526 |url=}}</ref> | |||
*** Reduce aortic complications in patients with [[Marfan syndrome]] | *** Reduce aortic complications in patients with [[Marfan syndrome]] | ||
*** Slow progression of AAAs in hypertensive patients | *** Slow progression of AAAs in hypertensive patients | ||
Revision as of 11:59, 29 October 2012
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Abdominal Aortic Aneurysm Microchapters |
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Differentiating Abdominal Aortic Aneurysm from other Diseases |
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Abdominal aortic aneurysm medical therapy On the Web |
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Directions to Hospitals Treating Abdominal aortic aneurysm medical therapy |
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Risk calculators and risk factors for Abdominal aortic aneurysm medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2] Aarti Narayan, M.B.B.S [3]
Overview
Risk factor modification including smoking cessation, management of hypertension, and lipid lowering are essential in reducing the risk of development and the rate of progression of abdominal aortic aneurysms.
Risk Factor Modification
- Smoking contributes to formation and rupture of aneurysm and smoking cessation should be encouraged in patients with an abdominal aortic aneurysm and in individuals with family history of abdominal aortic aneurysm
- Risk factors for atherosclerosis development and progression such as hypertension and hyperlipidemia should be controlled
Medical Therapy
ACEI
- These agents may be administered to control hypertension in patients with
Statins
- May reduce mortality in patients who have undergone an abdominal aortic aneurysm repair [1]
Beta blockers
- May have a beneficial effect on expansion of aneurysm from its effect on reduction of blood pressure. It is used routinely in patients with abdominal aortic aneurysm followed non-operatively [2]
- Reduce aortic complications in patients with Marfan syndrome
- Slow progression of AAAs in hypertensive patients
- In the absence of other indications for beta blockers, the evidence is insufficient to recommend using them routinely for the sole purpose of slowing atherosclerotic aneurysm growth
- Aspirin
- Antibiotics for possible chlamydia infection
- Assess for coronary, carotid and peripheral vascular disease
- Surveillance:
- 4 to 5.4 cm - monitor every 6 to 12 months
- 3 to 4 cm - monitor every 2 to 3 years
References
- ↑ Kalyanasundaram A, Elmore JR, Manazer JR; et al. (2006). "Simvastatin suppresses experimental aortic aneurysm expansion". Journal of Vascular Surgery. 43 (1): 117–24. doi:10.1016/j.jvs.2005.08.007. PMID 16414398. Unknown parameter
|month=ignored (help) - ↑ Hirsch AT, Haskal ZJ, Hertzer NR; et al. (2006). "ACC/AHA 2005 Practice Guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation". Circulation. 113 (11): e463–654. doi:10.1161/CIRCULATIONAHA.106.174526. PMID 16549646. Unknown parameter
|month=ignored (help)