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Calcium channel blockers increase the risk of aortic aneurysm and dissection

Tianfeng Ma1, Zeyu Cai2, Xinming Xu3

  • 1Department of Vascular and Endovascular Surgery, Chinese PLA General Hospital, Beijing, China.

Nature Communications
|December 24, 2025
PubMed

Insights

Calcium channel blockers (CCBs) may increase the risk of aortic aneurysm and dissection (AAD). CCBs also worsened AAD outcomes in mouse models and patients, suggesting caution in prescribing them for hypertension.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Vascular Biology

Background:

  • Aortic aneurysm and dissection (AAD) are critical vascular conditions lacking effective pharmacological treatments.
  • Impaired vascular smooth muscle cell (VSMC) contractility is implicated in AAD pathogenesis.
  • The precise role of calcium channel blockers (CCBs) in AAD development and progression is not well understood.

Purpose of the Study:

  • To investigate the association between calcium channel blocker (CCB) use and the risk of aortic aneurysm and dissection (AAD).
  • To evaluate the impact of CCBs on AAD progression and outcomes in preclinical models and human patients.

Main Methods:

  • Analysis of data from 501,878 participants in the UK Biobank, with a median follow-up of 13.5 years.
  • Assessment of CCB effects on aortic stiffness and AAD development in mouse models.
  • Evaluation of CCB impact on AAD regression in patients with type B aortic dissection post-endovascular repair.

Main Results:

  • CCB users exhibited a significantly higher risk of AAD (Hazard Ratio = 1.31) compared to untreated hypertensive individuals.
  • In mouse models, CCBs exacerbated aortic stiffness and promoted AAD development.
  • CCB use was associated with limited AAD regression in patients undergoing endovascular repair for type B aortic dissection.
  • Silencing of protein kinase cGMP-dependent 1 (PRKG1) attenuated CCB-induced AAD progression.

Conclusions:

  • Calcium channel blockers (CCBs) may be associated with an increased risk of aortic aneurysm and dissection (AAD).
  • CCBs might negatively impact AAD prognosis and post-surgical outcomes.
  • Caution is advised when prescribing CCBs to hypertensive patients at risk for AAD.

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