AARDVARK Trial design: Patients with small abdominal aortic aneuryms (AAAs) were randomized in a 1:1:1 fashion to either perindopril 10 mg once daily, amlodipine 5 mg, or placebo. Patient follow-up was 2 years. Results (p = 0.78) Primary outcome, annual AAA growth: perindopril, amlodipine, and placebo: 1.77 mm vs. 1.81 mm vs. 1.68 mm; p = 0.78 for perindopril vs. placebo. % ≥5.5 cm or referred for/undergoing AAA repair: 13.7% vs. 15.3% vs. 13.9%, p > 0.05 SBP ↓ 12 months: -9.5 vs. -6.7 vs. -0.5 mm Hg; DBP ↓ : -5.8 vs.-4.7 vs. -0.2 mm Hg; p < 0.001 for both medications vs. placebo 10 mm 5 Conclusions Perindopril was not superior to amlodipine or placebo in slowing AAA growth in patients with small AAAs, despite a greater reduction in BP Utility of both ACEi and ARBs in reducing aortic aneurysmal growth remains controversial Primary endpoint Amlodipine (n = 72) Perindopril (n = 73) Placebo (n = 79) Bicknell CD, et al. Eur Heart J 2016;Jul 1:[Epub]