45 year old woman, with high blood pressure is presenting with an AAA. Can antihypertensives control an aneurysm or does the patient need surgery?

Depend on the grade. of aneurysm present, and this is usually discussed with the cardiovascular surgeon/cardiology team, as the surgery is considered major surgery. Antihypertensives will be used intraoperatively and preoperatively to control the blood pressure. By itself, it's not the only treatment. If the aortic vessels are dissecting, this is considered life threatening. So, listen to your Dr.!
Far More Complex. The primary driver of AAA is atherosclerosis, the natural history of which is aneurysms just large enough to compensate for the white blood cell plaque volume within the artery walls. Thus: 1. optimize NMR lipoproteins (LDL 10 ?mol/L) , 2. HbA1c ?5.0% & 3. usual Systolic BP <120 mmHg resting (use fat soluble ACEI, eg Aceon, (perindopril) + Coreg as needed). Surgery Hi-risk & ?able value, esp. for size <6 cm ID.