Abdominal aortic aneurysm (AAA) is a significant health problem in the elderly. Efforts to limit the mortality
rate depend on early detection and elective AAA repair. The benefit of early detection of AAAs, by ultrasound screening
is limited since early repair of small AAA has been shown to provide no clinical advantage. There is currently no established
pharmacotherapeutic treatment for small AAAs.
In the first part of this review, we describe the potential mechanisms whereby statins can modulate the pathological processes
associated to experimental and human AAA. Among them, statins are able to regulate leukocyte recruitment and
immuno-inflammatory responses, platelet activation, oxidative stress, proteolysis and extracellular matrix breakdown.
However, controversial results have been obtained in experimental models of AAA.
In the second part of this review, we analyze the effect of statins in both, cardiovascular events on AAA patients and AAA
growth. Although statin treatment is recommended for all AAA patients with the aim of reducing the incidence of cardiovascular
events and death, controversial results have been shown between experimental and clinical studies regarding the
potential preventive effect on AAA growth. One potential reason for these discrepancies could be related to the fact that
statins reduce total cholesterol concentrations but do not modify HDL concentrations, the most sensitive predictor of AAA
among lipid markers. In this respect, it could be of interest to test the effect of drugs modulating plasma HDL concentrations
on AAA evolution.