Medical Management and Risk-Factor Modification for Unruptured Abdominal Aortic Aneurysm
For patients with an unruptured abdominal aortic aneurysm (AAA), evidence-based care targets cardiovascular risk reduction and blood pressure control to lower the risk of adverse outcomes. Management combines medical therapy with modification of measurable risk factors.
Treatment Approach
Management centres on antihypertensive therapy in patients meeting specified blood pressure thresholds, with additional interventions indicated or considered based on individual patient characteristics — the complete eligibility criteria, sequencing, and all components of the regimen are detailed in the full protocol.
Clinical Goals
- Systolic blood pressure <130 mm Hg
- Diastolic blood pressure <80 mm Hg
References
DOI: 10.1016/j.ejvs.2023.11.002
- In patients with AAA and an average SBP of ≥130 mm Hg, or an average DBP of ≥80 mm Hg, the use of antihypertensive medication is recommended to reduce risk of cardiovascular events.
- Uncontrolled hypertension is a known risk factor for aortic rupture and dissection; therefore, achieving an SBP goal of <130 mm Hg, and a DBP goal of <80 mm Hg with the use of antihypertensive therapy in those with hypertension and AAA can reduce adverse clinical outcomes, and some patients may benefit from more intensive lowering with an SBP goal of <120 mm Hg.
- In patients with AAA and evidence of aortic atherosclerosis, statin therapy at moderate or high intensity is recommended.
- In patients with AAA who smoke cigarettes, smoking cessation efforts are recommended.
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