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Propranolol for small abdominal aortic aneurysms: results of a randomized trial

J Vasc Surg. 2002 Jan;35(1):72-9. doi: 10.1067/mva.2002.121308.

Abstract

Purpose: Animal and human studies have suggested that beta-blockade may decrease the growth rate of aneurysms. We investigated whether propranolol decreases the growth rate of small abdominal aortic aneurysms (AAAs).

Methods: We randomly assigned patients with an asymptomatic AAA between 3.0 and 5.0 cm to receive either a placebo (n = 272) or propranolol (n = 276) in a double-blind fashion. Patients were observed for a mean of 2.5 years. The primary end point was the mean annual growth rate as determined by means of ultrasound scanning performed every 6 months. Secondary outcomes were death, surgery, withdrawal from study medication, and quality of life measured by means of the Short-form Health Survey (SF-36). The main analyses were performed by means of intention to treat.

Results: The two groups were similar at baseline: 84% were men with a mean age of 69 years and a mean AAA size of 3.8 cm. Fewer patients in the placebo group stopped their study medication (26.8% vs 42.4%; P =.0002). The annual growth rate was similar in the two groups (placebo, 0.26 cm/y vs propranolol 0.22 cm/y; P =.11). There was a trend toward more elective surgery in the placebo group (26.5% vs 20.3%; P =.11), but there was no difference in death rate (placebo, 9% vs propranolol, 12%; P =.36). Patients in the propranolol group had significantly poorer quality of life scores in the physical functioning, physical role, and vitality dimensions of the SF-36.

Conclusion: Patients with AAAs do not tolerate propranolol well, and the drug did not significantly affect the growth rate of small AAAs.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use*
  • Aged
  • Aorta, Abdominal / diagnostic imaging
  • Aorta, Abdominal / drug effects
  • Aortic Aneurysm, Abdominal / diagnostic imaging
  • Aortic Aneurysm, Abdominal / drug therapy*
  • Aortic Aneurysm, Abdominal / mortality
  • Double-Blind Method
  • Female
  • Follow-Up Studies
  • Health Status
  • Humans
  • Male
  • Propranolol / therapeutic use*
  • Quality of Life
  • Time Factors
  • Treatment Outcome
  • Ultrasonography

Substances

  • Adrenergic beta-Antagonists
  • Propranolol