Is losartan the true panacea for aneurysm disease? CON

Thoracic aortic aneurysm is a major health problem with multiple causes and potentially devastating consequences. At present, no large randomized trial has shown that medical therapy can significantly slow or halt the progressive dilatation that eventually leads to dissection and rupture. Surgical therapy, on the other hand, is very effective at preventing these feared complications. A recent study suggested that angiotensin-receptor blocking agents slow the development of aneurysm dilatation in Marfan syndrome. The authors argue that because of the multiple possible causes of aneurysm formation and the potential downsides of therapy, the available evidence is not strong enough to suggest that all patients with thoracic aortic aneurysm should be treated with angiotensin-receptor blocking agents.