Halloween is full of scares you can see coming, like the skeleton on the porch. The ones that worry me most are the quiet ones.
My friend Lucy died of a brain aneurysm in her sleep when she was in her early 60s. I miss her every day. Aneurysms are the kind of scare that doesn't announce itself, and one type is hiding in plain sight for a lot of women, in the biggest artery in the body.
What is an aortic aneurysm?
An aneurysm is a weak spot in an artery that bulges outward. It can grow for years without a single symptom. Aneurysms can happen in the brain, like Lucy's, and they can also happen in your aorta, the biggest artery you have.
Your aorta carries blood straight out of your heart to the rest of your body. It runs from your chest down into your belly, and every drop of blood your heart pumps goes through it first. Most people who have an aortic aneurysm only find out by accident, on a scan done for something else.
Why a stretched aorta is dangerous
Think of a balloon. When you first blow it up, the rubber is thick and strong. Keep blowing, and the rubber gets thinner and thinner until you can almost see through it. One more puff and it pops.
Your aorta works the same way. As it stretches, its wall gets thinner and weaker. The wall can tear (that's called a dissection) or even burst (a rupture). When that happens, it's life or death, and it usually comes with no warning at all.
Sudden, severe pain in your chest, back, or belly is your signal to call 911 right away. Don't wait to see if it passes, and don't drive yourself.
A simple test can find it
The good news is that a simple, non-invasive ultrasound can find an aortic aneurysm. It's quick and painless, and there's no radiation. It's worth asking your doctor about, especially if you've ever smoked, have high blood pressure, or have a family member who's had one.
Three things that raise your risk
1 - Your blood pressure, especially the bottom number
Your blood pressure reading has two numbers. The top one is the pressure when your heart squeezes. The bottom one is the pressure between beats, while your heart refills. That bottom number tells you how much force your arteries are under all the time, even when your heart is resting.
In a study of nearly 500,000 adults, people with a bottom number of 110 or higher had about a 75% higher risk of an aortic aneurysm than people whose bottom number was under 80. That constant pressure keeps pushing on the artery wall, day and night.
2 - Smoking
In another UK study of nearly 500,000 adults, people who smoked had about two and a half times the risk of a tear in the aorta compared with people who never smoked. And in a study that followed nearly 96,000 people for 26 years, heavy smokers were about two and a half times more likely to die from an aortic aneurysm or tear.
Quitting makes a real difference. In that big UK study, people who had quit smoking had about the same risk as people who never smoked. If you smoke, quitting is one of the best things you can do for your arteries, and your doctor can help you find a plan that works for you.
3 - A common type of antibiotic
This is the one most people have never heard of. Antibiotics called fluoroquinolones, such as Cipro (ciprofloxacin) or Levaquin (levofloxacin), are often prescribed for urinary tract infections, sinus infections, and pneumonia.
A 2026 review of more than 36 million people found the risk of an aortic aneurysm or tear was more than three times higher in the month after taking one. These drugs can weaken the collagen that holds artery walls together.
That doesn't mean you should turn down an antibiotic your doctor prescribes. But if you've been told your aorta is enlarged, make sure your doctor knows, and ask whether a different antibiotic would work the next time you need one.
Where food comes in
Food is one of the best ways to bring your blood pressure down. Eating less sodium is the step most people know. Eating less protein is the one most people don't.
Too much protein keeps your blood vessels tight
Your blood vessels relax by making a gas called nitric oxide, which lets them widen so blood flows through with less force.
When you eat more protein than your body needs, especially from animal foods, your body makes more of a compound called ADMA, which blocks nitric oxide. Your vessels stay tight, and the pressure inside them stays higher, pushing hard against an aorta that may already be stretched.
Most of us eat far more protein than we need. Cutting back helps keep your arteries flexible and your blood pressure down.
Potassium helps flush out sodium
Plant foods help in another way, too. They're rich in potassium, which helps your body flush out extra sodium and lets your blood vessel walls relax. Beans, potatoes, leafy greens, and bananas are all good sources.
If you have kidney disease or take certain blood pressure pills, check with your doctor about how much potassium is right for you. And if a lab test ever showed your potassium was high, here's what's usually behind it.
Fiber takes the pressure off, too
Those same foods are packed with fiber. Fiber-rich foods have a low calorie density, which means they fill you up on fewer calories. That makes it easier to lose extra weight, and losing weight takes even more pressure off your artery walls.
Try this tonight: bake a potato, split it open, and top it with warm black beans, a handful of chopped spinach, and a spoonful of low-sodium salsa. You get potassium, fiber, and a cozy fall dinner in one.
The scare worth paying attention to
Not every scary thing is wearing a mask. Some are hiding in plain sight, in a number on your blood pressure cuff.
If you don't know your numbers, this is a great week to check them. And if your bottom number has been creeping up, talk with your doctor, and start with what's on your plate.
Sources
2 - Scientific Reports, 2025: tobacco smoking and aortic dissection risk in the UK Biobank
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