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| | Title: | Atherosclerosis. What is atherosclerosis? | | Article: | Atherosclerosis is the disease, which affects blood
vessels and brings numerous complications, including
myocardial infarction and ischemic stroke. It looks
like a "hardening" or "furring" of the arteries,
caused by the formation of multiple plaques within the
arteries. The name came from the Greek. Athero means
paste and sclerosis means hardness.
Atherosclerosis is a major health problem in developed
nations. There is compelling evidence that chronic
inflammation of the vasculature plays significant role
in atherosclerosis pathogenesis.
Atherosclerosis currently is understood as a chronic
inflammatory disease, which develops in response to
injury of the arterial wall. It is characterized by
the complex development of an occlusive and
prothrombotic atheroma.
The pathogenesis of the atherosclerotic lesion
involves endothelial dysfunction, decrease in Nitrous
Oxide availability, misbalanced adhesion molecule
expression, leukocyte adhesion and infiltration,
generation of cytokines and growth factors, foam cells
accumulation, extracellular lipid and matrix
accumulation, metalloprotease activation and
eventually proliferation of smooth muscle cells in the
walls of the vessels. The innermost layer of the
artery is called the endothelium. The process involves
accumulation of fat, cholesterol, cellular waste,
calcium and fibrin in the wall of an artery. The
result is development of plaque. Cytokines initiate
and support the atherogenic process. Plaque blocks the
blood flow. In addition bleeding into the plaque or
formation of a blood clot on the broken plaque may
block the whole artery. The result is a heart attack
or stroke.
Treatment
Symptoms of atherosclerosis, for example heart attack
or brain stroke, are treated on their own.
The way to treat atherosclerosis is basically the way
to prevent complications.
First step is simple: stop smoking, exercise
regularly. It works always, but sometimes more drastic
measures required.
The next step is treating cardiovascular diseases.
Lipoprotein (fat) disbalance, diabetes, high blood
pressure, homocysteine greatly speed up
atherosclerosis plaque formation. Fighting these
diseases helps a lot. The target cholesterol level is
ideally less than 4mmol/L and triglycerides level less
than 2mmol/L.
Anticoagulants (anti-clotting drus), Omega 3 oils from
fish, exercise and weight reduction proved to be very
effective.
The medications named statins are one of the most
successful in reducing atherosclerotic complications.
Statins fight cholesterol. Rosuvastatin caused some
regression of atherosclerotic plaque within the heart
vessels. However, majority of people require a
combination of several drugs.
Vitamin Niacin lowers some lipoproteins. Niacin also
shifts bad low density lipoproteins to beneficial high
density lipoproteins. Combination of statins, niacin,
and intestinal cholesterol absorption drugs (ezetimibe
and fibrates) were the most successful in improving
clinical outcomes in secondary prevention.
A new approach in the treatment of atherosclerosis
might be use of MAPK inhibitors since MAPK plays
critical role in the pathways of pro-inflammatory
cytokines generation. This possibility is under
investigation at present. | | Author: | Aleksandr Kavokin, MD, PhD | | System: | Arteries | | Subject: | Atherosclerosis | | Abstract: | Atherosclerosis is a major health problem in developed
nations. There is compelling evidence that chronic
inflammation of the vasculature plays significant role
in atherosclerosis pathogenesis. | | Website: | www.kavokin.com | | Time: | 18:13 | | Reference: | www.rdoctor.com | | Reference 2: | |
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©2006 Kavokin.com
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Articles by Aleksandr Kavokin, MD, PhD
Doctor-Robot (Free section)