Does medical therapy for thoracic aortic aneurysms really work? Are beta-blockers truly indicated? CON.

Thoracic aortic aneurysms (TAA) often represent the final manifestation of hereditary or degenerative disease processes. TAA are primarily caused by age-related degenerative changes. In this article, the authors highlight the most common pathophysiologic mechanisms responsible for TAA formation and review the paucity of evidence supporting the spectrum of medical therapies for TAA other than renin-angiotensin inhibition. More clinical trials on TAA are required before medical therapies such as beta-blockers, statins, and macrolide antibiotics can be recommended.