Effect of β-Adrenergic Blockade on the Growth Rate of Abdominal Aortic Aneurysms

To the Editor.—I read the recent article in the Archives by Leach et al¹ with great interest. The effect of propranolol hydrochloride on other types of aneurysmal disease could also be explored. For example, the incidence of coronary artery aneurysms in a coronary artery surgery study of 20087 patients was 5%.² The cause was primarily atherosclerotic or congenital, with over half secondary to atherosclerosis. The main complications reported were rupture with sudden death, thrombosis, and myocardial infarction secondary to embolization. Medical treatment generally consists of the use of antithrombotic drugs. Often a patient has associated coronary artery stenosis and poststenotic dilation and aneurysm formation. Often these patients are receiving propranolol for treatment of associated disease, such as hypertension, angina pectoris, and the control of certain types of cardiac arrhythmias. Therefore, in a large medical center such as Yale (New Haven, Conn), where many coronary angiographic studies are