Silver Lining in the Dark Cloud of Aneurysm Disease

An ascending aortic aneurysm is a common and very much unwelcome diagnosis that has never been associated with anything positive. We believe, however, that there actually is a silver lining to this disease: aortic root and ascending aortic aneurysms actually protect against atherosclerosis. We have found that patients with ascending aneurysms have both decreased arterial calcification and carotid intima-media thickness, late and early indicators of atherosclerosis, respectively. In addition to these clinical data, we also found data regarding molecular mechanisms, genetic studies, and pharmacologic evidence that corroborate our clinical findings, in particular, evidence regarding matrix metalloproteinases and transforming growth factor-β pathways. In this article, we lay out the evidence that has been accruing for the protective effect of ascending aneurysms against atherosclerosis.