This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Effect of propanolol on the expansion of abdominal aortic aneurysms: a randomized study. BJS 2000; 87: 499-499.
Published: 6th December 2002
Authors: A. B. M. Wilmink, C. S. F. F. Hubbard, N. E. Day, C. R. G. Quick
Background
This study investigated whether propanolol reduces the growth rate of small screen‐detected abdominal aortic aneurysms (AAAs).
Method
This was a prospective blinded randomized study of men with an aneurysm between 3 and 4·5 cm detected in a community‐based screening programme.
Results
Some 477 patients were randomized: 256 to take propanolol 40 mg and 221 controls. The mean growth rate in the propanolol group was 0·06 (95 per cent confidence interval 0–0·14) versus 0·1 (0·02–0·19) mm in the control group (P = 0·48). Propanolol decreased growth in 59 patients with an AAA larger than 3·9 cm (0·13 (0–0·31) versus 0·43 (0·26–0·60) mm in controls; P = 0·02). Compliance with propanolol treatment was poor: 31 per cent of the active treatment group were on beta blockers compared with 15 per cent in the control group. The growth in patients actually taking beta blockers was 0·24 (0·11–0·38) versus 0·25 (0·17–0·33) mm (P = 0·91). Stiffness measurements did not differ significantly between patients taking beta blockers and controls. Subgroup analysis showed an increased stiffness in the patients on beta blockers (mean(s.d.) 31·1(4·2) versus 23·4(1·9) in controls in aortas larger than 3·4 cm; P = 0·057).
Conclusion
Propanolol is not associated with a significant reduction in the growth of small aneurysms. Propanolol reduces the growth of aneurysms larger than 4 cm. Compliance with propanolol treatment for small aneurysms is low. Treatment of small screen‐detected aneurysms with propanolol cannot be recommended. © 2000 British Journal of Surgery Society Ltd
Full text