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Besides managing BP, what else can slow the growth rate?
I'm a 48yo M, diagnosed in 2019 with an ascending aneurysm at 4.2-4.3. I have been getting regular scans and I thought it was not growing, but today my doctor told me that the last CT scan shows it at about 4.5. My BP is controlled (small dose of olmesartan), I don't smoke, I rarely drink, and I am fairly physically active. I'm 5'10" / 197lbs, so I could lose a bit of weight.
What bothered me was that the doctor basically said, "You're doing what you can, just come back at the end of the year for your next scan", like the growth is inevitable and unavoidable.
So that's my question - what else can I do to slow the growth? I know that sometimes this condition advances rapidly without apparent reason, but that (fortunately) doesn't seem to be the case for me - mine is progressing at around 1mm a year. Nonetheless, it feels like there SHOULD be something else to do to slow things down.
What am I missing?
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Here it is, this is Dr Galpin and Andrew Huberman (both very highly regarded scientists) discussing breathing while lifting weights/exercising , the BP part starts around min 1:49
Again it is not the type of exercise that is a problem, is what we do while doing the exercise to build the "push" to complete the exercise, most of us hold our breath and grunt, and that's what creates the spike. When my Dr told me about bench presses and crunches he was refering to the fact that people tend to hold their breaths a lot while doing those, but honestly it is the same when doing squats, etc and any other exercise that reqires that big "push" and if the weight is high the reps last longer
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4 ReactionsI took that suggestion just now because I do have a BP cuff - interesting result. My BP was basically unchanged (around 105/75), but my HR went up considerably (resting HR 65, right after 40 pushups 95). I wonder if that should be a consideration.
Did you have a NST (Nuclear Stress Test) when my TAA was found in 12/23 the Cardiologist called for the NST he said the test was fine my BP under the test remained within the limits and basically cleared me for the gym. I don't lift heavy I use mostly machines and when I do lunges I only use 5 lbs. However I do a lot of cardo so for that I wear my Fitbit and watch my heart rate I keep it within the vigorous HB if I am in the high HB I take it back down. I also check my BP every morning my doctor said the BP should be 130/80 or below and it has been average 110/71 with meds so good there. I am going for my second scan to measure in June so hopefully I will still be at 4 cm. So the best advice here is for you to ask your doctor what you should do and if they didn't schedule the NST I would ask for one. It's the gold standard in these situations at least that is what my doctors said.
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2 ReactionsI'm jumping in here when I probably shouldn't. I've read that some people have an exaggerated blood pressure response to exercise. If you had the treadmill test that @deedth64 mentioned, it would probably identify whether it was a concern. I said I probably shouldn't jump in because I don't know anything more than that -- IF you had it, I don't know if that alone would be high enough for long enough to make a difference in the growth rate. I also don't know if the normal BP after exercise means you don't have it.
I'm where you were at beginning of your journey, though about 15 years older. I have an aneurysm but no lifestyle factors that indicated I should (or genetic factors so far as anyone knows). I'm crossing my fingers for my first follow-up scan in April that it won't have grown. However, if it has grown, on the plus side, it seems you can only fare better in the surgery the younger you are.
Two things that both my Doctors mentioned to me regarding growth rate. My Primary and Cardiologist stated that I need to watch my BP which is why I take it daily and my cholesterol levels specifically the LDL not just the overall number. My last blood test which was this month (March) said my LDL was 91 and my doctors said not good enough so they put me on Zetia they want that number to be 70 or below.
Thing I wanted to mention here is that it wasn't just a treadmill test it was a nuclear test meaning they inject dye into your veins while you're running they take pictures of your heart pre-exercise and then post exercise so they get clear concise pictures of how your heart is performing under extreme pressure also it looks for any type of blood flow that might be slowed down to to blockage NST doesn't really show blockages but it'll show areas of concern so there are two types of stress tests there's just the treadmill without the dye and then there's the nuclear stress test with the dye that's the one I suggest people get in these type of situations because it does give you a clear picture of what you and your doctors are dealing with
Is there another test then can do rather then the nuclear stress that is compatible. I'm not so comfortable when the die injection. I've had many over the years at 72 years of age.
I think it depends on what the goal of the stress test is. I had one after coronary atherosclerosis was discovered during a CAC test. The aortic dilation was discovered at the same time. Yet, I think the stress test was only to identify potential blockages in the coronary arteries. I'm not sure they are given if the only concern is an aneurysm. Have your stress tests been related to aneurysm?
Honestly the amount of dye they inject is minimal and you drink water immediately after the test and right before the second set of pictures and the dye flushes out. I don't see the value of the test not having the pictures of my arteries done and w/out the dye they can't get a clear picture of what's going on. I have 4 so far in my lifetime and never had an issue.
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1 ReactionCorrect, the stress test only measures the blood flow and BP during high stress activity which gave me the clearance for the gym and the CT Calcium test found the ectasia. But there is a direct link between BP, Cholesterol and the growth of the dilation. So by measuring the BP during the test my doctor got a better idea of how "stressful" I am when exercising. I can tell you a never ever get up to the point they had me at during the test, I am always in the moderate exercise range rarely in the high intensity.