Invited Commentary

Atherosclerosis-Challenging the Assumptions

Authors: Dana E. King, MD, MS

Abstract

Atherosclerosis is a condition in which an inner artery wall thickens as a result of the accumulation of fatty plaque. It is a chronic inflammatory condition enhanced by low-density-lipoproteins, white blood cells, and a variety of cytokines. Conventional wisdom regarding the resulting cardiovascular risk is that age, race, hypertension, diabetes, obesity, smoking, and low-density lipoprotein (LDL)-cholesterol all contribute significantly to atherosclerosis and the risk of future cardiac events. However, the process of atherosclerosis is more complicated than a list of risk factors, and it does not progress evenly throughout the vascular tree; the reasons for this phenomenon are not completely understood.1

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References

1. Staels B. Cardiovascular biology: a cholesterol tether. Nature 2002;417:699–701.
 
2. Kelley RE, DasMahapatra P, Wang J, et al. Prevalence of atherosclerotic plaque in young and middle-aged asymptomatic individuals: the Bogalusa Heart Study. South Med J 2011;104:803–808.
 
3. Novo S, Carità P, Corrado E, et al. Preclinical carotid atherosclerosis enhances the global cardiovascular risk and increases the rate of cerebro- and cardiovascular events in a five-year follow-up [published online ahead of print January 25, 2010]. Atherosclerosis 2010;211:287–290.
 
4. Tomkin GH. Atherosclerosis, diabetes and lipoproteins [review]. Expert Rev Cardiovasc Ther 2010;8:1015–1029.
 
5. Knoflach M, Kiechl S, Penz D, et al. Cardiovascular risk factors and atherosclerosis in young women: atherosclerosis risk factors in female youngsters (ARFY study) [published online ahead of print February 10, 2009]. Stroke 2009;40:1063–1069.
 
6. Pinkhasov RM, Wong J, Kashanian J, et al. Are men shortchanged on health? Perspective on health care utilization and health risk behavior in men and women in the United States [review]. Int J Clin Pract 2010;64:475–487.