Patient discussions

Advise the patient to avoid contact sports and strenuous physical activities (e.g., isometric heavy weight lifting, pushing, or straining that would require a Valsalva manoeuvre) to reduce aortic wall shear stress due to sudden rises in arterial blood pressure during exercise.[2][18]​ Aerobic exercise may be acceptable after careful consideration and discussion, ideally keeping the patient's heart rate less than 100 beats per minute. Patients should follow up for surveillance imaging and blood pressure control.[5]​ Smoking cessation and control of hyperlipidaemia is important for overall vascular health.[18]​ Counsel the patient to maintain a heart-healthy diet.

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