2) Factors that weaken the aortic wall--Processes like inflammation, lipoprotein deposition, and nutritional deficiencies work to weaken the supportive tissue of the aorta. Correction of these factors helps keep the aortic wall from weakening, slowing or stopping any enlargement and inhibiting atherosclerotic plaque formation. The steps include:

--Correction of lipoprotein abnormalities (e.g., small LDL and lipoprotein(a)). Note that this is not the same as correcting "cholesterol" abnormalities. Cholesterol does not cause heart disease; lipoproteins (lipid-carrying proteins) cause heart disease. Cholesterol is just a convenience of measurement. Measuring and quantifying lipoproteins provides genuine insight into how the aorta can be weakened. You will have to ask your doctor to specifically order this blood test.

--Reductions in carbohydrate intake-Which reduces blood glucose and thereby glycation, or glucose-modification of proteins, a situation that causes inflammation. I favor elimination of all products made from wheat, cornstarch, and sugars, an enormously effective way to correct small LDL, low HDL, and high triglycerides, as well.  

--"Normalization" of vitamin D-Restoration of vitamin D is helpful to counteract the inflammatory responses in the aortic wall that weaken it. I aim for a blood 25-hydroxy vitamin D level of 60-70 ng/ml. The dose of vitamin D required to achieve this level varies from individual to individual, but doses usually range from 4000 to 8000 units per day. 

--Vitamin C supplementation--Collagen crosslinking for aortic wall strength requires adequate vitamin C. A simple supplement (e.g. 500 mg) of a naturally-sourced vitamin C, along with plentiful vegetables and some fruit, should do it.

--Omega-3 fatty acids from fish oil-Fish oil corrects multiple causes of plaque, especially lipoproteins that derive from excessive triglycerides. I use a minimum omega-3 (combined EPA and DHA) of 1800 mg per day or more.

I have patients who have kept their initially enlarged aortas stable for over 10 years. While it may seem a bit complicated, just a few efforts like those listed above can potentially keep your aorta healthy.