Upregulation of PDE5A expression in smooth muscle cells induced by angiotensin II decreases cGMP signaling, contributing to vasoconstriction (Kim et al., 2005) while downregulation of PDE5A is associated with human thoracic aortic aneurysms (Cesarini et al., 2019). Here, PDE5A is linked to thoracic aortic aneurysm.