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From the article:

“Atherosclerotic plaques and the risk factors that cause them, including hypertension, classically have been considered important potential causes of the expansion of the aorta,” says Bijoy Khandheria, M.D., a Mayo Clinic cardiologist and study author. “Intuitively, it makes sense that high blood pressure would stretch the vessel walls and make them more likely to become enlarged. This study shows that while these risk factors are highly important in a host of diseases and conditions, they are bit players when it comes to causing the dilatation of the aorta that can lead to aneurysm.”

[…]

The study found that age, gender and body size together account for one-third or more of the cases of aortic dilatation, while atherosclerosis and related risk factors only explained 3 percent.

“There has been a tendency recently to refer to aneurysms as ‘athersclerotic aneurysms,’” explains Dr. Khandheria. “But the fact that plaques – even complex or severe ones – are very common, while aneurysms are rare, supports the conclusion that atherosclerosis and its risk factors are not likely to blame for aneurysms in the major blood vessels of the chest. Other factors and processes, including genetic diseases similar to Marfan syndrome, seem to be more important.

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