Should we start beta-blockers and ARBs for dilated aortic roots?
Again, unfortunately, the short answer is, we don't know. Almost all the good literature is limited to patients with Marfan syndrome, so it's hard to extrapolate outside that clinical context. I'm attaching a good review of medical management of TAAs, which basically says for patients with Marfan syndrome, previous dissection, or bicuspid aortic valves, there is some literature to support the use of beta-blockers or ARBs, and that these medications might have some synergy. Of course the data is more nuanced than that, so I hope you'll take some time to read the relevant pages from this review.
Seminars in Vascular Surgery 2022;35(1):16-34
