Why does Abdominal aortic aneurysm happen?
Last updated September 7, 2026.
An abdominal aortic aneurysm happens when the wall of the aorta in your belly weakens and stretches wider than normal, most often because of smoking, high blood pressure, and plaque buildup in the artery. The aorta is built from elastic layers that flex with every heartbeat, and anything that damages or stiffens those layers lets pressure push the wall outward over time. Smoking is the single strongest contributor, followed by long-standing high blood pressure and atherosclerosis. Genetics matter too, so having a parent, brother, or sister with an aneurysm raises your own chance, as do inherited connective tissue conditions such as Marfan syndrome. Most aneurysms grow slowly and cause no symptoms at all, which is why a one-time ultrasound is recommended for men aged 65 to 75 who have ever smoked. Quitting smoking, treating blood pressure, and keeping cholesterol controlled are the changes that slow growth the most.
What to do
- Stop smoking first: Quitting is the change most strongly tied to slower aneurysm growth, and support such as counseling plus nicotine replacement roughly doubles your odds of success.
- Ask about screening: If you are a man aged 65 to 75 who has ever smoked, ask your doctor about a one-time abdominal ultrasound, which is painless and takes a few minutes.
- Know your family history: Tell your doctor if a parent, brother, or sister had an aortic aneurysm, since that may mean earlier screening for you.
- Treat blood pressure and cholesterol: Take prescribed medicines consistently, since steady pressure and lower cholesterol reduce stress on the aortic wall.
- Keep follow-up scans: If an aneurysm is already known, attend every scheduled ultrasound so any change in size is caught while repair is still planned rather than urgent.
- Call 911 for sudden severe pain: Sudden deep pain in your belly, back, or side with dizziness or fainting needs emergency care right away.
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