Pharmacological therapy for patients with abdominal aortic aneurysm.

Abdominal aortic aneurysm (AAA) is a common and life-threatening disease characterized by progressive dilatation and rupture, and has a mortality rate of up to 90%. Surgical repair is recommended for large aneurysms, whereas small aneurysms are managed by 'watchful waiting'. The recently introduced AAA screening programs reduce aneurysm-related mortality; however, aneurysm detection leads to psychological problems and a reduced quality of life of patients. The success of pharmacological therapy for AAA in small animals continues to provide insights into the pathogenetic mechanisms of this disease. As a result, medications, such as doxycycline, roxithromycin and statins, have been used to limit the growth of AAAs in small human studies with promising results. However, randomized trials with large numbers of patients and long follow-ups are required for the thorough investigation of safe and effective medical therapies. Control of cardiovascular risk factors, particularly smoking cessation, may result in a reduced growth of the AAA and improve overall patient care.