You can significantly lower your risk of developing an aneurysm by managing a handful of controllable factors: blood pressure, smoking, diet, sleep, and exercise habits. Aneurysms form when a weakened spot in an artery wall balloons outward, and most of the forces that cause that weakening are things you can influence. While some people carry genetic risks that can’t be changed, the majority of prevention comes down to protecting the structural integrity of your blood vessels over time.
Keep Blood Pressure in a Safe Range
High blood pressure is the single most important modifiable risk factor for both brain aneurysms and aortic aneurysms. Every point of systolic blood pressure (the top number) increases your risk. A genetic study found that each unit increase in systolic blood pressure raised the odds of developing a brain aneurysm by about 7%, and diastolic pressure showed a similar effect. The damage is cumulative: years of elevated pressure slowly stretches and weakens artery walls, creating the conditions for a bulge to form.
Current clinical trials are testing whether keeping systolic pressure below 120 mmHg offers better protection against aneurysm growth and rupture than the standard target of 120 to 140 mmHg. While those results are still pending, the principle is clear. Lower pressure means less mechanical stress on your arteries. If you don’t know your numbers, getting a blood pressure reading is the most useful first step you can take.
Quit Smoking, or Never Start
Smoking is the other major driver of aneurysm formation, and the data on this is stark. Compared to nonsmokers, people who smoke have roughly 2.7 times the risk of developing a brain aneurysm, based on genetic evidence. That risk climbs with the number of cigarettes smoked per day. Smoking damages artery walls through chronic inflammation and breaks down the elastic proteins that give blood vessels their flexibility and strength.
Quitting makes a real difference. In a study tracking patients with small aortic aneurysms over three years, those who stopped smoking saw their aneurysms grow at nearly half the rate of those who kept smoking: 0.09 cm per year compared to 0.16 cm per year. The growth rate correlated directly with blood levels of a nicotine byproduct, meaning the more someone smoked, the faster the aneurysm expanded. Even if you already have a small aneurysm, stopping tobacco use is one of the most effective things you can do to slow its progression.
Reduce Sodium and Eat for Vascular Health
High sodium intake drives up blood pressure and appears to directly affect the health of blood vessel walls. The World Health Organization recommends no more than 5 grams of salt per day (about 2,000 mg of sodium), but the average intake in Western countries runs between 8 and 12 grams daily. That excess is consistently associated with hypertension and higher cardiovascular risk across large population studies.
Practical ways to cut sodium include cooking more meals at home, reading labels for sodium content, and reducing processed and restaurant foods, which account for most dietary sodium. A diet rich in fruits, vegetables, whole grains, and lean protein (often described as a Mediterranean or DASH-style eating pattern) supports lower blood pressure and healthier arteries overall.
Address Sleep Problems
Insomnia is an often-overlooked risk factor. Genetic research has identified it as an independent contributor to brain aneurysm formation, with a 15% increase in risk. Poor sleep raises blood pressure, promotes inflammation, and disrupts the body’s ability to repair vascular tissue. If you regularly struggle to fall or stay asleep, treating that issue does more than improve your energy. It may be protecting your arteries.
Exercise Wisely
Regular moderate exercise lowers blood pressure, reduces inflammation, and improves vascular health. It is protective. But certain types of intense exertion deserve caution, particularly heavy weightlifting combined with breath-holding (the Valsalva maneuver). Studies have documented that heavy resistance training with a Valsalva maneuver can spike arterial pressure to extreme levels, as high as 480/350 mmHg. That sudden surge is transmitted directly to the blood vessels in the brain and can potentially trigger the rupture of an existing aneurysm.
This doesn’t mean you should avoid the gym. It means breathing steadily through lifts, avoiding maximal one-rep efforts if you have risk factors, and favoring moderate resistance with higher repetitions. Aerobic exercise like walking, swimming, and cycling is consistently beneficial.
Cholesterol-Lowering Medications and Aneurysm Stability
For people who already have a detected aneurysm, statins (cholesterol-lowering drugs) may help slow its growth. These medications work through several pathways beyond cholesterol: they reduce inflammation in the aneurysm wall, protect against oxidative damage to cells, and help preserve the elastic proteins and smooth muscle that give the artery its structural strength. By maintaining the integrity of these components, statins can help stabilize an aneurysm and slow its expansion. This is something to discuss with your doctor if you’ve been diagnosed with an aneurysm or are at elevated risk.
Know the Warning Signs of an Unruptured Aneurysm
Most unruptured aneurysms, especially small ones, cause no symptoms at all. But a larger unruptured brain aneurysm can press on surrounding tissue and produce noticeable signs:
- Pain above and behind one eye
- A dilated pupil
- Double vision or other vision changes
- Numbness on one side of the face
- Seizures
A particularly important warning sign is a “sentinel headache,” caused by a small leak from the aneurysm before a full rupture. This presents as a sudden, extremely severe headache that can last days to two weeks. A more serious rupture often follows. Recognizing this headache as abnormal and seeking immediate medical attention can be lifesaving.
Who Should Get Screened
For abdominal aortic aneurysms, the U.S. Preventive Services Task Force recommends a one-time ultrasound screening for men aged 65 to 75 who have ever smoked (defined as 100 or more cigarettes in a lifetime). Men in that age range who have never smoked may still benefit from selective screening. The Task Force recommends against routine screening in women who have never smoked and have no family history, while noting that evidence is still insufficient to make a firm recommendation for women who have smoked or have a family history.
For brain aneurysms, there is no universal screening recommendation for the general population. However, screening with imaging is typically offered to people with a strong family history (two or more first-degree relatives with brain aneurysms) or those with certain genetic conditions.
Genetic Conditions That Raise Your Risk
Some people are born with connective tissue disorders that make their artery walls inherently weaker. If you have one of these conditions, prevention involves more aggressive monitoring and earlier intervention. The most significant include:
- Marfan syndrome: Causes highly penetrant aortic root aneurysms that can lead to life-threatening dissections without surgical repair.
- Vascular Ehlers-Danlos syndrome: Results from a defect in a key structural protein (type III collagen), leading to fragile arteries prone to aneurysms, dissection, and rupture in large and medium-sized vessels.
- Loeys-Dietz syndrome: Characterized by aggressive, early-onset aneurysms and dissections throughout the arterial tree.
- Aneurysm-osteoarthritis syndrome: Causes early joint problems alongside aortic aneurysms and dissections.
Several other gene mutations affecting smooth muscle function and elastin also raise risk. If you have a family history of aneurysms, aortic dissection, or unexplained sudden death, especially at a young age, genetic counseling can help clarify whether you carry one of these conditions and what monitoring schedule makes sense for you.