Do β-Blockers Really Work for Prevention of Aortic Aneurysms?: Time for Reassessment.

Since 1994, when a small 70-patient study seemed to demonstrate that β-blocker treatment could help prevent aortic aneurysms in patients with Marfan syndrome, β-adrenergic-blocking drugs have been increasingly believed to reduce the progression of aortic aneurysms in the general population with aortic disease. This literature review examines the scientific evidence of this treatment and questions whether β-blocker treatment for aortic aneurysms should continue to be uniformly recommended. Five separate clinical trials studying the effects of β-blockade therapy in patients with Marfan syndrome are analyzed, in addition to four other clinical trials studying the effects of β-blockade therapy in patients without Marfan syndrome. The analysis suggests that the scientific evidence for β-blocker treatment is unconvincing, because β-blockade therapy fails to consistently reduce aortic aneurysm growth in patients with or without Marfan syndrome. It is alarmingly clear that prospective, multicenter clinical trials are greatly needed to test the efficacy of this now conventional therapy in a more robust scientific fashion.