An aneurysm is a localized bulge or ballooning that forms in the wall of a blood vessel, most commonly an artery. This weakening can occur in various parts of the body, with the aorta and the brain’s blood vessels being frequent locations. If an aneurysm grows sufficiently large, it can rupture, leading to severe internal bleeding that can be life-threatening.
What Aneurysms Are and Their Risk Factors
Aneurysms represent an expansion of an artery’s wall, often exceeding 50% of its normal diameter. They can be found in several areas, including the abdominal aorta, the thoracic aorta in the chest, and arteries within the brain, known as cerebral aneurysms. The potential for rupture, which can cause internal bleeding and lead to severe complications or death, is the main concern.
Several factors contribute to the weakening of blood vessel walls, increasing the likelihood of aneurysm formation. Non-modifiable risks include age, being male (especially for abdominal aortic aneurysms), a family history of aneurysms, and certain genetic conditions like Ehlers-Danlos or Marfan syndrome. Caucasian descent is also associated with a higher risk of aortic aneurysms.
Other risk factors are modifiable, meaning individuals can take steps to address them. High blood pressure (hypertension) strains artery walls, making them more susceptible to weakening and rupture. Smoking damages blood vessel walls and increases the risk of aneurysm development and rupture. Atherosclerosis, characterized by plaque buildup in arteries, also contributes to vessel wall damage. High cholesterol, heavy alcohol use, and the use of certain drugs like cocaine can also elevate risk by affecting blood pressure and vascular health.
Lifestyle Choices for Prevention
Adopting a healthy lifestyle can reduce the risk of developing aneurysms. A balanced diet, rich in fruits, vegetables, and whole grains, supports vascular health. Limiting saturated fats, trans fats, and sodium helps manage blood pressure and cholesterol levels. The DASH (Dietary Approaches to Stop Hypertension) diet, for example, focuses on these principles to support heart health.
Regular physical activity strengthens the cardiovascular system and helps control blood pressure, cholesterol, and weight. Adults should aim for at least 150 minutes of moderate-intensity exercise, or 75 minutes of vigorous activity, each week, alongside muscle-strengthening activities. Quitting smoking is another impactful step, as tobacco use damages blood vessel walls and is a major modifiable risk factor for aneurysms. Smoking cessation improves vascular health and reduces the likelihood of aneurysm development and rupture.
While moderate alcohol consumption might have varied effects, heavy alcohol use consistently increases blood pressure and weakens arteries, raising aneurysm risk. Limiting alcohol intake is a recommended preventive measure. Managing stress also contributes to vascular well-being, as chronic stress can lead to elevated blood pressure and unhealthy lifestyle habits. Techniques such as mindfulness, deep breathing exercises, and engaging in hobbies can help reduce stress levels.
Medical Management for Prevention
Beyond lifestyle adjustments, medical management helps individuals with existing conditions that increase aneurysm risk. High blood pressure (hypertension) is a factor in aneurysm formation and rupture, requiring consistent management. Healthcare providers may prescribe antihypertensive medications, such as RAAS inhibitors, beta-blockers, or calcium channel blockers, to lower blood pressure and reduce the strain on arterial walls. One study indicated that RAAS inhibitors could reduce the risk of brain aneurysm rupture by 18% in people with high blood pressure.
High cholesterol, particularly high levels of LDL (“bad”) cholesterol, contributes to atherosclerosis, where plaque builds up in arteries and weakens their walls. Medications like statins can help manage cholesterol levels and prevent plaque accumulation, reducing aneurysm risk. For individuals with diabetes, controlling blood sugar levels is also beneficial, as diabetes increases the risk of atherosclerosis. The diabetes medication metformin has shown an association with a reduced risk of aneurysmal subarachnoid hemorrhage. Adherence to prescribed medications and regular medical check-ups are important for managing these chronic conditions and mitigating aneurysm risk.
Screening and Early Detection
Screening for aneurysms is not a universal recommendation but is targeted towards individuals with specific risk factors. Early detection allows for monitoring or timely intervention before an aneurysm ruptures. For abdominal aortic aneurysms (AAAs), a one-time ultrasound screening is recommended for men aged 65 to 75 who have a history of smoking. Men in the same age range who have never smoked may also be selectively screened based on individual risk factors, such as a family history of aneurysms.
Individuals with a strong family history of aneurysms may be candidates for screening for cerebral aneurysms. Certain genetic disorders, like polycystic kidney disease, also warrant consideration for screening. Common screening methods include non-invasive imaging tests such as ultrasound, CT scans (including CT angiography), and MRIs (including MR angiography). These tests provide detailed images of blood vessels to identify aneurysms, assess their size, and monitor their growth over time.