Abdominal and thoracic aortic aneurysms are a significant cause of morbidity and mortality. Although the mechanisms leading to abdominal and thoracic aortic aneurysm development differ, there are shared cardinal features—including breakdown of the extracellular matrix, generation of reactive oxygen species, and inflammation.1 Aortic aneurysms are typically asymptomatic until they dissect or rupture, the latter of which is associated with a mortality rate of over 80%. According to the current practice guidelines, the mainstay of treatment relies on managing risk factors to prevent rupture, including smoking cessation, blood pressure control, and ultimately, surgical repair for enlarging aneurysms. Preventive surgeries have associated perioperative morbidity and mortality. Therefore, increased understanding of the mechanisms involved in the pathophysiology of aortic aneurysms has the potential to broaden the scope of targeted medical therapies for prevention and management. The findings of Zhu et al in this issue offer insight into an important association between aldosterone and the increased risk of aneurysmal disease.
