Definition
An aortic aneurysm is defined as an abnormal and exaggerated dilation of a wall of the aorta, an expression of the weakening of its elastic component; the aortic aneurysm manifests itself as a sort of balloon bulge, the consequences of which can be lethal for the patient.
Abdominal aortic aneurysm: the pathological dilation of the aorta is located in its abdominal tract
Thoracic aortic aneurysm: dilation of the aorta is limited to the level of the thoracic area of the artery
Causes
The precise cause triggering the aortic aneurysm is unknown; however, numerous elements have been identified that can contribute to the manifestation of the pathology: previous aorta lesions (eg laceration of the aorta wall), traumatic lesions (eg road accidents), connective tissue diseases (eg Marfan syndrome, Ehlers-Danlos syndrome). Smoking and hypertension are two of the most important risk factors for aortic aneurysm.
Symptoms
Sometimes the aneurysm develops so slowly that the patient is not aware of the disease and has no symptoms. In other cases, the aortic aneurysm can lead to alteration of the appetite, difficulty in swallowing and breathing during even slight exertion (thoracic aortic aneurysm), chest pain, back pain, perception of the heartbeat near the navel, hoarseness and cough.
Information on Aortic Aneurysm - Drugs for the Treatment of Aortic Aneurysm is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Aortic Aneurysm - Aortic Aneurysm Drugs.
drugs
The presence of an aortic aneurysm reflects a clinical emergency, given the extremely dangerous possible complications. In some patients, the aortic aneurysm is diagnosed late because it is asymptomatic, although the possibility of complications is still high; in other patients, the aortic aneurysm manifests itself suddenly: in the latter case, the risk of aneurysm rupture increases exponentially, as does the risk of death. Not surprisingly, patients who have a history of aneurysm must be constantly monitored over time by specialized personnel, precisely to avoid any possible relapse.
There is no drug able to reverse the disease after it has occurred: the drugs are however essential as a prevention for aortic aneurysm. (In the next paragraph the most used drugs in therapy to reduce the risk will be listed)
The therapy for aortic aneurysm is purely surgical (indicated when the diameter of the aorta exceeds 5.5 cm):
- "Open" surgery: consists in removing the damaged section of the aorta and replacing it with a synthetic tube
- Endovascular surgery: practice reserved only for some patients
- Other heart operations (when, for example, the aneurysm depends on dysfunctions of the heart valves)
- Emergency surgery: indicated for aneurysm rupture. Many patients who experience a similar rupture die before reaching the hospital.
THE DRUGS BELOW AS RECOMMENDED ARE USEFUL ONLY FOR PREVENTIVE THERAPY WITH THE AORTIC ANALYSIS
Drugs for the treatment of hypertension : considering that hypertension is one of the risk factors most involved in the onset of aortic aneurysm, the administration of drugs to control blood pressure is essential to reduce the risk of aneurysm.
Beta-blockers are able to reduce blood pressure by slowing the heart rate, such as:
- Atenolol (eg. Atenol, Tenoretic, Tenormin): for the treatment of arterial hypertension, also for the prevention of aortic aneurysm, it is recommended to take 100 mg of active ingredient a day. After 15 days of treatment, the patient should start getting the first benefits; if this were not the case, it is possible to associate a diuretic drug with beta blockers.
- Metoprolol tartrate (eg Seloken, Lopresor, Metoprolol AGE): take 1-2 tablets of 100 mg, 1-2 times a day. The dosage just described is approximate: consult your doctor.
- Bisoprolol emifumarato (ex.Concor): for the treatment of hypertension as a prevention of aortic aneurysm, it is recommended to take 5-10 mg of active per day. The dose can be changed based on the severity of the disease and the patient's response. Consult your doctor.
Sartan drugs are indicated when the administration of a beta blocker is not sufficient to guarantee the control of blood pressure. Furthermore, sartans (angiotensin II antagonists) are also indicated in the context of Marfan syndrome, independently of an imbalance in pressure values (we briefly recall that this syndrome is one of the possible factors triggering the aortic aneurysm).
- Losartan (eg. Neo-Lotan, Lortaan, Lozid): for the prevention of aortic aneurysm, in the context of hypertension, it is recommended to start therapy with a dose of 50 mg of active, to be taken orally once a day. The maintenance dose varies from 25 to 100 mg a day.
- Valsartan (eg Tareg): start therapy for the treatment of hypertension as a prevention of Marfan syndrome, with a minimum dose of drug (80 mg), to be taken once a day. Eventually, if no observable therapeutic effects appear after a month of therapy, increase the dose up to a maximum of 320 mg a day. Consult your doctor.
- Olmesartan (eg. Olmetec): initially, the dosage suggests to administer low doses of drug (10 mg / day), to then eventually increase the dosage up to 40 mg a day. It is possible to associate another antihypertensive drug (Hydrochlorothiazide: Esidrex, belonging to the class of diuretics).
Drugs for the treatment of high cholesterol : since high cholesterol promotes the formation of atherosclerotic plaques in the arteries, responsible for the narrowing of the lumen of the vessels, the administration of cholesterol-lowering drugs reduces both the risk of hypercholesterolemia and complications in the context of a possible aortic aneurysm. Statins are the most used in therapy for this purpose:
- Atorvastatin (eg Totalip, Torvast, Xarator): this statin is probably the most used in therapy for the treatment of high cholesterol, along with simvastatin. In general, the initial dose varies from 10 to 40 mg per day, to be taken orally. The dose of 40 mg per day is indicated for patients requiring a reduction in bad cholesterol of more than 45%. Continue with this dosage for 2-4 weeks. The maintenance dose includes the intake of 10-80 mg of active per day. Consult your doctor.
- Lovastatin (eg Lovinacor, Tavacor, Rextat): start the treatment with a dose of 20 mg of drug, taken once a day, together with the meal. The maintenance dose is expected to take 10-80 mg a day, possibly divided into two doses. The drug is also available in the form of slow-release tablets: in this case, start the therapy with 20-40-60 mg of drug, to be taken once a day, before going to bed; patients who require a small reduction in bad cholesterol, at risk of aortic aneurysm, can only take 10 mg of drug per day. The maintenance dose varies from 10 to 60 mg a day, depending on the severity of the condition. The active ingredient is also available in association with niacin.
- Simvastatin (eg. Zocor, Simvastat, Omistat, Quibus, Setorilin). It is recommended to start the treatment with a dose of drug ranging from 10 to 20 mg, to be taken orally, once a day. The maintenance dose is expected to take 5-40 mg of active per day (once a day, in the evening). Sometimes the drug is formulated with other active ingredients, such as sitagliptin (eg Juvisync), useful for combating diabetes in the context of hypercholesterolemia, and ezetimibe (eg Vytorin).
For further information: see the article on drugs for the treatment of high cholesterol
Smoking cessation drugs
Among the most used drugs in smoking cessation therapy, we recall:
- Nicotine-based smoking cessation patches (eg Nicopatch): generally, apply one patch a day, on dry, cleansed skin; the patch should be applied on the arm, or on an upper part of the body, always trying to position it at a different point, to avoid local irritation.
- Varenicline (eg Chapmix, 25-28-56 tablets): take 0.5 mg of active per os once a day in the first three days of smoking cessation treatment. From the 4th to the 7th day of therapy, increase the dose to 0.5 mg of active twice daily. From the eighth day on, take 1 mg of active twice a day.
The smoking habit can adversely affect the origin and the manifestation of the aortic aneurysm, therefore it is recommended to stop smoking.
