These are general guidelines intended for those with thoracic aortic aneurysms and dissection. Individuals may have unique disease-specific manifestations and other health conditions that require additional consideration and restrictions. Before you start a new type of exercise you should consult with your aortic care provider. If your aortic care provider gives you advice that differs from these recommendations, please follow their advice.
Guidelines for living with thoracic aortic aneurysms and dissections
- Tell your clinicians about anxiety or depression and get treatment. If untreated, these conditions may raise your blood pressure.
- Avoid tobacco and tobacco products.
- Take your antihypertensive medications every day. We recommend beta blockers (metoprolol, bisoprolol, atenolol, carvedilol) as the first choice and angiotensin receptor blockers (losartan, Irbesartan, valsartan, telmisartan) if needed. Sudden discontinuation of your medications may cause a hypertensive crisis that greatly increases your risk for an acute dissection.
- Do not take stimulants such as ephedra, cocaine, amphetamines and prescription medications that are not safe for people with high blood pressure, as these may trigger acute dissections. If you are unsure about whether a medication or dietary supplement is safe for you, please consult with your clinician.
- Viagra, Cialis and other medications intended to treat erectile dysfunction may increase the risk of acute aortic dissections. Therefore, we do not prescribe or recommend these drugs for individuals with aortic disease.
- Fluoroquinolone antibiotics such as ciprofloxacin and levofloxacin that are used to treat urinary and respiratory infections may increase your risk to have an aortic dissection. If you are prescribed one of these antibiotics, please ask your clinician for alternatives.
- Get regular imaging tests of your heart and blood vessels. The frequency of these tests depends on the type of aortic disease you have. If you are not sure if you need these tests, talk to your cardiologist.
- Talk with your family members about your diagnosis and make your clinicians aware of your family history, because thoracic aortic aneurysm and dissections can “run in families” even when no genetic syndrome like Marfan syndrome is present in affected family members.
- Please recognize that vascular diseases of all kinds are lifelong conditions that put you at risk for future complications, even if you have had previous interventions. Make plans for what to do in the event of emergencies and share them with those who live with or care with you.
Exercise and Activity Recommendations
- Exercise is part of a healthy lifestyle because it can lower your blood pressure and should be included in the treatment plan for all patients with aortic disease.
- Before starting exercise, make sure that your blood pressure is well controlled.
- Take a beta blocker (such as metoprolol or atenolol) every day. This will reduce your risk to develop high blood pressure with exercise.
- Moderate aerobic activities (walking, jogging, running, yoga, pilates) are safe.
- Stay below your maximum target heart rate: (220 – your age) X 80%. This defines the upper limit of moderate exercise.
- Lifting light weights is OK, as long as you stop well before you can’t do another rep.
- When lifting, do not strain your chest or abdomen (Valsalva maneuver). The amount that individuals can lift safely will vary. The most weight that you can lift without straining your chest or abdomen is a reasonable weight limit for you.
- Isometric exercises (planking, wall sits), where you contract your muscles but do not move your joints, may not be safe for you if you have recently had aortic surgery or an acute aortic dissection. Your clinician can provide a letter explaining these restrictions if needed.
- If you are contemplating more intensive aerobic exercise, please consult with a clinician. We may recommend a treadmill stress test to determine whether it is safe for you before you are cleared for vigorous physical activity
- Sexual activities are safe.
- Avoid contact sports.