Friday, January 17, 2020

Anti-hypertensive in Marfan

Q: Which group of anti-hypertensives showed to decrease the risks of acute aortic complications in Marfan syndrome by directly improving the elastic properties of the aorta?

Answer: Beta-blockers

Beta-blockers are unique as it has shown not only to decrease the myocardial contractility and pulse pressure but has shown to improve the elastic properties of the aorta, particularly in patients with an increased aortic root diameter.  
The dose is targetted to maintain the heart rate after submaximal exercise to keep less than 100 beats/minute.

Calcium Channel Blockers (CCBs) should be avoided in Marfan syndrome.




1. Hiratzka LF, Bakris GL, Beckman JA, et al. 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with Thoracic Aortic Disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine. Circulation 2010; 121:e266. 

2. Loeys BL, Dietz HC, Braverman AC, et al. The revised Ghent nosology for the Marfan syndrome. J Med Genet 2010; 47:476.

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