Table of Contents
Overview
Definition and Mechanism
Atherosclerosis is defined as a chronic inflammatory disease characterized by the narrowing of arteries due to the accumulation of cholesterol plaque, which can lead to severe health complications such as stroke, heart attacks, and dementia.[3.1] This condition is primarily driven by a lipid-driven process initiated by the buildup of low-density lipoprotein (LDL) and remnant lipoprotein particles, particularly in areas of arteries where blood flow is disturbed.[3.1] The progression of atherosclerosis is often asymptomatic until significant complications arise, such as a heart attack or stroke, typically occurring when an artery is more than 70% blocked.[4.1] The disease is a major contributor to mortality in westernized societies, accounting for approximately 50% of all deaths.[3.1] In terms of its mechanism, atherosclerosis involves a complex interplay of lipid accumulation, inflammation, and the formation of fibrous caps over plaques, which can rupture and lead to thrombosis.[3.1] The inflammatory response is crucial in the development and progression of the disease, as it facilitates the recruitment of immune cells to the arterial wall, exacerbating plaque formation and instability.[3.1]Symptoms and Diagnosis
Atherosclerosis is a gradual process that often begins in early adolescence and can remain asymptomatic for decades. The initial stages of atherosclerosis involve endothelial dysfunction, inflammatory responses, and foam cell formation, which can lead to lipid retention and chronic inflammation in the arterial walls.[32.1] As the condition progresses, fatty streaks develop into fibrous plaques, some of which may become vulnerable to rupture.[31.1] Early symptoms of atherosclerosis are typically absent, making it difficult for individuals to recognize the condition until significant blockage occurs. As plaque accumulates, symptoms may manifest as chest pain, fatigue, or difficulties in walking.[36.1] Notably, symptoms often do not appear until arteries are more than 70% blocked, at which point complications such as heart attacks or strokes may arise.[37.1] Risk factors for atherosclerosis include a family history of early heart disease, age, and gender, with males generally at higher risk than females, although the latter's risk increases post-menopause.[33.1] Healthy lifestyle choices, such as regular exercise, a balanced diet low in fats, and stress management, are crucial in preventing or slowing the progression of atherosclerosis.[36.1] Diagnosis typically involves stress tests and imaging techniques to assess blood flow and arterial health.[37.1]History
Ancient Understanding
Atherosclerosis has been recognized as an "ancient disease," with its characterization dating back to the medical writings of ancient Egyptians, Greeks, and Romans. The term "atherosclerosis" itself is derived from Greek, meaning both "softening" (athere) and "hardening" (skleros), which reflects the complex nature of the disease affecting major blood vessels in the body.[54.1] Despite being commonly perceived as a modern ailment linked to contemporary lifestyles, research indicates that atherosclerosis was prevalent in preindustrial populations, including hunter-gatherers, suggesting its existence across a broad span of human history.[71.1] The Horus study, which examined four ancient populations, revealed that the presence of atherosclerosis in these groups implies that the disease is an inherent aspect of human aging rather than solely a consequence of specific diets or lifestyles.[71.1] The understanding of atherosclerosis evolved significantly over time, particularly with the pioneering work of Nikolai N. Anichkov in the early 20th century, who first demonstrated the critical role of cholesterol in the disease's development through his experiments in 1913.[51.1] This foundational research laid the groundwork for the modern understanding of atherosclerosis as a chronic inflammatory disease, initiated by the retention and accumulation of apoB-rich lipoproteins in the arterial wall.[52.1]Evolution of Treatment Approaches
The evolution of treatment approaches for atherosclerosis has been significantly influenced by historical insights and advancements in understanding the disease. The historical context of atherosclerosis dates back to ancient times, with early teachings from figures such as Galen, which laid the groundwork for later hypotheses, including the response-to-injury hypothesis proposed by Russel Ross. This progression has led to the contemporary understanding of the vulnerable plaque, a critical concept in the pathology of atherosclerosis.[76.1] Over the past two centuries, atherosclerosis and its complications, such as atherothrombosis, have remained leading causes of mortality worldwide. Recent research has revealed that atherosclerosis is not solely a lipid-driven condition but rather a multifactorial disease influenced by inflammatory mediators. This understanding has prompted the development of new treatment options that target these underlying mechanisms, including the use of colchicine, which has been associated with a significant reduction in ischemic cardiovascular events.[69.1] In clinical practice, aggressive treatment strategies aimed at reducing risk factors are recommended for high-risk patients, emphasizing the importance of early intervention and long-term management. Given that the signs and symptoms of atherosclerosis can span decades, the efficacy of treatments such as statins is best evaluated over extended periods rather than short-term randomized trials.[68.1] Despite advancements in treatment protocols, existing therapies often focus on alleviating symptoms rather than reversing the disease, highlighting the need for ongoing research and innovation in therapeutic approaches.[69.1] The contributions of pathologists and researchers in the latter half of the twentieth century have been pivotal in shaping our understanding of atherosclerosis. Their work has established a comprehensive body of evidence regarding the pathology and pathogenesis of the disease, influencing clinical practices and treatment decisions.[78.1] Furthermore, the growing interest in testing lipoprotein(a) levels in clinical settings reflects an evolving understanding of risk factors associated with atherosclerosis, particularly in individuals with a familial predisposition or unexplained cardiovascular events.[79.1]Causes And Risk Factors
Lifestyle Factors
Atherosclerosis is significantly influenced by various lifestyle factors that contribute to its development and progression. A sedentary lifestyle, characterized by low levels of physical activity and fitness, is strongly associated with increased morbidity and mortality from atherosclerotic cardiovascular disease (ASCVD).[92.1] Additionally, modern lifestyle habits such as high-fat diets, smoking, and excessive alcohol consumption have been identified as critical risk factors for atherosclerosis.[94.1] Dietary patterns play a crucial role in managing cholesterol levels, which is vital for preventing atherosclerosis. Foods that lower low-density lipoprotein (LDL) cholesterol, such as those rich in fiber, healthy fats, and proteins, can significantly reduce the risk of heart disease.[96.1] For instance, incorporating nuts like pistachios and garlic into the diet has been shown to lower cholesterol levels and improve overall cardiovascular health.[96.1] Furthermore, adherence to a Mediterranean diet, which emphasizes fruits, vegetables, whole grains, and healthy fats, has been linked to a 29% lower risk of ASCVD over a five-year period.[99.1] Moreover, maintaining a healthy weight through regular physical activity and a balanced diet is essential for reducing the risk factors associated with atherosclerosis, including obesity and high blood pressure.[92.1] Public health initiatives targeting these lifestyle choices, such as promoting physical activity and healthy eating habits, can effectively mitigate the prevalence of atherosclerosis in various populations.[94.1]Genetic and Medical Conditions
Atherosclerosis is influenced by a complex interplay of genetic and epigenetic factors that contribute to individual predisposition and the disease's clinical outcomes. Evidence suggests that genetic predisposition plays a significant role in determining susceptibility to atherosclerosis, with multiple candidate genes identified that may influence the vessel wall's response to atherogenic stimuli, such as modified low-density lipoprotein.[124.1] The heritability of coronary artery disease (CAD), a condition closely related to atherosclerosis, is substantial, with studies indicating that approximately 50% of the phenotypic variance in CAD can be attributed to genetic factors.[126.1] Genome-wide association studies (GWAS) have identified numerous common genetic variants associated with CAD, underscoring the polygenic nature of the disease.[126.1] Moreover, the interaction between genetic factors and various atherogenic stimuli occurs in several cell types, including macrophages, lymphocytes, endothelial cells, and vascular smooth muscle cells.[125.1] This interaction highlights the complexity of atherosclerosis, as it is not solely determined by genetic predisposition but also by environmental factors and lifestyle choices that can modulate the effects of these genetic influences.[124.1]Recent Advancements
Innovative Treatment Strategies
Recent advancements in the treatment of atherosclerosis have focused on innovative strategies that address the multifactorial nature of the disease, which is characterized by lipid dysregulation, inflammation, and vascular pathology. Traditional therapies, primarily lipid-lowering drugs such as statins, remain the cornerstone of treatment; however, they often fall short of reversing the disease and primarily focus on alleviating symptoms.[129.1] Statins have demonstrated significant improvements in prognosis for reducing atherosclerotic heart disease, but their use can be limited by side effects, leading to non-adherence in some patients.[132.1] Emerging treatment paradigms are increasingly targeting the inflammatory processes associated with atherosclerosis. Recent research has highlighted the role of adaptive immunity, particularly T-cells, in disease progression, suggesting that immunotherapy could play a transformative role in atherosclerosis management.[141.1] For instance, the CANTOS trial, which utilized the interleukin-1β inhibitor canakinumab, validated the inflammatory hypothesis of atherothrombosis and opened avenues for further exploration of immunomodulatory therapies.[137.1] Additionally, novel therapeutic approaches, including tolerogenic vaccines and monoclonal antibodies, are being investigated for their potential to reduce atherosclerotic plaque size and improve patient outcomes.[142.1] Another promising area of research involves the development of targeted drug delivery systems, particularly through nanomedicine. These systems aim to enhance the efficacy and safety of treatments by delivering drugs directly to atherosclerotic lesions, thereby minimizing systemic side effects and improving therapeutic outcomes.[147.1] The integration of stimuli-responsive nanodrug delivery systems represents a significant advancement in the field, allowing for more precise targeting and controlled release of therapeutic agents.[147.1]Prevention And Lifestyle Changes
Heart-Healthy Diet
A heart-healthy diet plays a crucial role in the prevention of atherosclerosis and cardiovascular disease (CVD). Various dietary patterns have been associated with a reduced risk of atherosclerotic cardiovascular disease (ASCVD). Notably, the Mediterranean diet, the Dietary Approach to Stop Hypertension (DASH), and plant-based dietary patterns have shown significant benefits in lowering ASCVD risk in observational studies and randomized controlled trials.[173.1] A diet rich in fruits, vegetables, legumes, nuts, seeds, and fatty fish is optimal for preventing ASCVD.[173.1] Specific foods, such as beets, which are high in dietary nitrates, can enhance blood vessel function and reduce inflammation, thereby helping to prevent atherosclerosis.[174.1] Additionally, oats have been found to significantly lower risk factors associated with atherosclerosis, including high total and LDL cholesterol levels.[174.1] The consumption of nuts and seeds is also beneficial, as they may help regulate blood sugar levels, a known risk factor for atherosclerosis.[174.1] Furthermore, olive oil has been linked to reduced inflammatory markers associated with atherosclerosis and a decreased risk of heart disease.[174.1] The evidence strongly supports that a diet low in salt and animal products, combined with a high intake of plant-based foods such as whole grains, fruits, vegetables, legumes, and nuts, is associated with a lower risk of atherosclerosis.[184.1] Fiber-rich diets are particularly effective in reducing the risk of heart attack and stroke, potentially due to their role in decreasing inflammation through the production of short-chain fatty acids in the gut microbiome.[190.1] A higher intake of dietary fiber has been correlated with a reduced risk of cardiovascular disease, with recommendations suggesting an intake of 25 to 38 grams per day, although many individuals fall short of this target.[191.1] Moreover, omega-3 polyunsaturated fatty acids, found in fatty fish and certain seeds, are essential for cardiovascular health. They have been shown to reduce inflammation, lower blood pressure, and decrease triglyceride levels, thereby lowering the risk of heart disease.[194.1] The American Heart Association recommends omega-3 fatty acids for patients with heart failure to reduce the risk of cardiovascular hospitalization and mortality.[195.1] Foods such as salmon, mackerel, flaxseed, and chia seeds are excellent sources of omega-3s, and individuals with heart disease may benefit from higher intakes or supplements.[196.1]Physical Activity and Lifestyle Modifications
Regular physical activity and lifestyle modifications play a crucial role in the prevention of atherosclerosis and its associated cardiovascular diseases. Engaging in consistent physical activity is associated with improved cardiovascular health, particularly in reducing blood pressure and enhancing overall fitness levels, which are vital for mitigating the risk of atherosclerosis.[185.1] The American Heart Association emphasizes that a heart-healthy lifestyle should include not only regular exercise but also dietary changes, smoking cessation, stress management, and adequate sleep.[171.1] A heart-healthy diet, which is integral to lifestyle modifications, consists of fruits, vegetables, whole grains, lean proteins, and healthy fats while limiting sodium, saturated fats, trans fats, and added sugars.[170.1] Specific dietary patterns, such as the Mediterranean or DASH diets, have been recommended for their beneficial effects on cardiovascular health.[181.1] Furthermore, maintaining a healthy weight through physical activity and proper nutrition is essential, as obesity is a significant risk factor for cardiovascular diseases, including atherosclerosis.[179.1] The implementation of lifestyle changes can significantly reduce the risk of developing atherosclerosis. For instance, regular physical activity not only helps in weight management but also positively influences various cardiovascular risk factors, including cholesterol levels and blood pressure.[180.1] Studies have shown that lifestyle interventions, such as those involving a Mediterranean diet combined with exercise, can lead to a substantial reduction in the risk of atherosclerotic cardiovascular disease events.[181.1] In addition to individual efforts, community engagement and education are vital in promoting awareness and motivating individuals to adopt healthier lifestyle choices. Interventions that involve community health workers have been shown to effectively prevent cardiovascular diseases by addressing risk factors and encouraging lifestyle modifications.[178.1] Overall, a comprehensive approach that includes physical activity, dietary changes, and community support is essential for the effective prevention of atherosclerosis and the promotion of cardiovascular health.In this section:
Treatment Options
Pharmacological Interventions
Pharmacological interventions for atherosclerosis primarily focus on managing lipid levels and reducing cardiovascular risk. Statins are the cornerstone of pharmacotherapy for the prevention of atherosclerotic cardiovascular disease (ASCVD). These medications work by inhibiting the enzyme 3-hydroxy-3-methylglutaryl-CoA reductase, which is crucial in the cholesterol biosynthetic pathway, leading to a significant reduction in low-density lipoprotein cholesterol (LDL-C) levels.[238.1] Statins not only lower LDL cholesterol but also enhance the expression of LDL receptors in the liver, facilitating further reduction of plasma LDL cholesterol levels.[239.1] The effectiveness of statins is well-documented, with the most potent statins achieving a mean reduction in LDL cholesterol of 55% to 60% at maximum dosages.[219.1] They are widely prescribed, with approximately one in four Americans over the age of 40 taking a statin to mitigate the risk of myocardial infarction and ischemic stroke.[219.1] In addition to lowering cholesterol, statins contribute to plaque stabilization by reducing lipid content and promoting the formation of thicker fibrous caps around atheromas, which helps prevent plaque rupture.[218.1] While statins are generally well tolerated, they can have adverse effects, including musculoskeletal symptoms and an increased risk of diabetes.[220.1] However, the frequency of these side effects is low, and for many patients, the cardiovascular benefits of statin therapy significantly outweigh the potential risks.[221.1] In cases where patients experience side effects, dose adjustments or alternative treatments may be necessary.[222.1] In addition to statins, other pharmacological strategies include medications that target lipid metabolism, such as bile acid sequestrants, fibrates, and cholesterol absorption inhibitors.[210.1] These agents can be used in conjunction with statins or as alternatives for patients who cannot tolerate statin therapy. Overall, the management of atherosclerosis through pharmacological interventions is multifaceted, aiming to control lipid levels and reduce the risk of cardiovascular events.Surgical Procedures
Recent advancements in surgical procedures for treating atherosclerosis have significantly improved patient outcomes compared to traditional methods. One notable development is the genetic modification of grafts, which enhances their patency and resistance to atherosclerosis, leading to improved graft integration and a reduced rate of re-stenosis following procedures such as coronary bypass and percutaneous coronary intervention.[212.1] In the realm of vascular surgery, techniques such as directional atherectomy (DA) and drug-coated balloon (DCB) angioplasty have emerged as transformative approaches for managing complex femoropopliteal atherosclerotic disease. These innovations have revolutionized treatment paradigms and enhanced patient outcomes by effectively addressing blockages in the arteries.[213.1] Coronary artery bypass grafting (CABG) has also seen remarkable progress, with innovative techniques and refined approaches that have transformed both patient outcomes and treatment paradigms. Recent reviews highlight the evolution of CABG, emphasizing the importance of these advancements in improving surgical results.[214.1] Furthermore, minimally invasive coronary bypass surgery, robotic coronary bypass, and hybrid approaches have been developed to overcome traditional shortcomings in CABG. These methods aim to avoid sternotomy, utilize arterial grafts, and minimize the reliance on cardiopulmonary bypass, thereby enhancing recovery and reducing complications.[215.1] Overall, these advancements reflect a significant shift in the surgical management of atherosclerosis, focusing on improving efficacy and patient safety.References
[3] Atherosclerosis - StatPearls - NCBI Bookshelf — Atherosclerosis is a chronic inflammatory disease of the arteries and is the underlying cause of about 50% of all deaths in westernized society. It is principally a lipid-driven process initiated by the accumulation of low-density lipoprotein and remnant lipoprotein particles and an active inflammatory process in focal areas of arteries particularly at regions of disturbed non-laminar flow at
[4] Atherosclerosis: Symptoms, Causes & Treatment - Cleveland Clinic — You may not have symptoms of atherosclerosis until you have complications like a heart attack or stroke. Atherosclerosis is the gradual buildup of plaque in the walls of your arteries. You may notice symptoms of atherosclerosis if your artery is more than 70% blocked. Coronary artery disease (CAD, which can lead to a heart attack) happens in the arteries that supply blood to your heart. This includes using a stethoscope to listen to your heart and blood flow through your arteries. Atherosclerosis treatment includes lifestyle changes, medications, procedures or surgeries. Depending on the location of your atherosclerosis, you may see a cardiologist (heart), nephrologist (kidneys), neurologist (brain and spine) or vascular surgeon (blood vessels).
[31] The Pathology of Atherosclerosis: Plaque Development and Plaque ... — Atherosclerosis develops over the course of 50 years, beginning in the early teenage years. The causes of this process appear to be lipid retention, oxidation, and modification, which provoke chronic inflammation at susceptible sites in the walls of all major conduit arteries. Initial fatty streaks evolve into fibrous plaques, some of which develop into forms that are vulnerable to rupture
[32] Pathophysiology of Atherosclerosis - PMC - PubMed Central (PMC) — The first steps in atherosclerosis development include endothelial dysfunction, followed by inflammatory response and foam cell formation. There is an extensive list of miRNAs that regulate endothelial function, such as miR-221, miR-503, miR-217, miR-34a, miR-181b, miR-155, miR-126, miR-1, miR-223, miR-145, miR-146a, miR_92a, or miR10a .
[33] Atherosclerosis from Newborn to Adult—Epidemiology, Pathological ... — Having a family history of early heart disease increases the likelihood of atherosclerosis development. Age plays a role as the cumulative effects of risk factors over time can lead to atherosclerosis progression. Males tend to have a higher risk compared to females, although the risk in females increases after menopause.
[36] Atherosclerosis: Symptoms, Causes, Diagnosis, and Treatment — Atherosclerosis can put blood flow at risk as your arteries become blocked, and it can cause clots to form. It’s the usual cause of heart attacks, strokes, and peripheral artery disease (PAD) -- which together are called cardiovascular disease . Stress test, in which you exercise while health care professionals watch your heart rate, blood pressure, and breathing. Coronary artery disease: Stable plaques in your heart's arteries cause angina (chest pain). It takes years for atherosclerosis to develop into noticeable symptoms like leg and chest pain, high blood pressure, and kidney failure. Healthy habits like exercise, a low-fat and balanced diet, not smoking, and lowering stress will help prevent or slow damage to your heart and other organs due to atherosclerosis.
[37] Atherosclerosis: Symptoms, Causes & Treatment - Cleveland Clinic — You may not have symptoms of atherosclerosis until you have complications like a heart attack or stroke. Atherosclerosis is the gradual buildup of plaque in the walls of your arteries. You may notice symptoms of atherosclerosis if your artery is more than 70% blocked. Coronary artery disease (CAD, which can lead to a heart attack) happens in the arteries that supply blood to your heart. This includes using a stethoscope to listen to your heart and blood flow through your arteries. Atherosclerosis treatment includes lifestyle changes, medications, procedures or surgeries. Depending on the location of your atherosclerosis, you may see a cardiologist (heart), nephrologist (kidneys), neurologist (brain and spine) or vascular surgeon (blood vessels).
[51] Nikolai N. Anichkov and His Theory of Atherosclerosis - PMC — Nikolai N. Anichkov (1885-1964) first demonstrated the role of cholesterol in the development of atherosclerosis. His classic experiments in 1913 paved the way to our current understanding of the role of cholesterol in cardiovascular disease.
[52] Century of Milestones and Breakthroughs Related to the Immune ... — After more than a century of atherosclerosis research, during which the wheel has been reinvented countless times, it is now widely accepted that atherosclerosis is a chronic inflammatory disease of large- and medium-sized arteries, initiated in response to the retention and accumulation of apoB-rich lipoproteins in the artery wall.
[54] HISTORY OF MEDICINE: History of atherosclerosis — HISTORY OF MEDICINE: History of atherosclerosis HISTORY OF MEDICINE Study the history of medicine to understand how it has explained birth, death, and disease. History of atherosclerosis Atherosclerosis is an ‘ancient disease’ beginning with its characterization in medical works of ancient Egyptians, Greek and Romans. History of atherosclerosis History of Paracetamol The discovery of quinine marked the beginning of modern pharmacology. History of Metformin Its history can be t... History of Food Processing History of Painting The Hearst Papyrus: A Window into Ancient Egyptian Medicine - Dec 28 2024 The Kahun Gynaecological Papyrus: Ancient Egypt's Oldest Medical Text - Dec 07 2024 Gregor Mendel, often hailed as the "Father of Genetics," revolutionized biology with his mid-19th-century discoveries about heredi...
[68] Atherosclerosis: from biology to pharmacological treatment — In patients with high risk, aggressive treatment to reduce risk factors should be instituted early and maintained for years. Since the incubation period and signs and symptoms of atherosclerosis span decades, randomized trials of a few years' duration provide little insight into outcomes of statin treatment over those 40-60 years.
[69] Advancements in the Treatment of Atherosclerosis: From Conventional ... — Atherosclerosis is a leading cause of morbidity and mortality worldwide, driven by a complex interplay of lipid dysregulation, inflammation, and vascular pathology. Despite advancements in understanding the multifactorial nature of atherosclerosis and improvements in clinical management, existing therapies often fall short in reversing the disease, focusing instead on symptom alleviation and
[71] Atherosclerosis Across 3,800 Years Of Human History: The Horus Study of ... — Atherosclerosis Across 3,800 Years Of Human History: The Horus Study of Four Ancient Populations (ACCEL) - American College of Cardiology Take-awaysAtherosclerosis is commonly considered a disease of modern times and related to modern lifestyles.The Horus study suggests that atherosclerosis was common in four preindustrial populations, including a pre-agricultural hunter-gather population, and across a wide span of human history.The presence of atherosclerosis in pre-modern human beings suggests that the disease is an inherent component of human aging and not associated with any specific diet or lifestyle. YOU ARE HERE: Home > Latest in Cardiology > Atherosclerosis Across 3,800 Years Of Human History: The Horus Study of Four Ancient Populations (ACCEL)
[76] A historical perspective towards a non-invasive treatment for ... - PubMed — The history of atherosclerosis and cardiovascular disease dates back to ancient times. From the teachings of Galen to the response-to-injury hypothesis of Russel Ross, we have now arrived at the concept of the vulnerable plaque. ... A historical perspective towards a non-invasive treatment for patients with atherosclerosis Neth Heart J. 2009
[78] Innovators in atherosclerosis research: A historical review — The review focuses on the contributions of these pathologists and allied investigators on the development of a comprehensive body of knowledge of the pathology and pathogenesis of atherosclerosis and its clinical consequences of coronary heart disease, stroke and peripheral arterial disease. (Table 1).
[79] Atherosclerosis Treatment Through the Years | IMA Clinical Research — Given the link between Lp (a) and atherosclerosis, there is a growing interest in incorporating testing Lp (a) levels in the blood within clinical practice. This may help in refining risk assessments and screens, particularly in individuals with a strong family history of atherosclerosis or who have unexplained, premature cardiovascular events.
[92] Lifestyle factors as determinants of atherosclerotic cardiovascular ... — A sedentary lifestyle, low levels of physical activity and fitness, poor dietary patterns, and psychosocial stress are strongly associated with increased morbidity and mortality from atherosclerotic cardiovascular disease (ASCVD). Conversely, engaging in regular physical activity, maintaining optimal fitness levels, adhering to a heart-healthy dietary pattern, effectively managing body weight
[94] Global and national burden of atherosclerosis from 1990 to 2019: trend ... — Secondly, modern lifestyle habits, including high-fat diets, lack of exercise, smoking, and excessive alcohol consumption, have increased atherosclerosis risk. Lastly, there has been a rise in chronic diseases such as diabetes and hypertension, which are significant risk factors for atherosclerosis. [ 30 ]
[96] 10 Foods that Prevent Clogged Arteries - BlackDoctor.org — Most are heart-healthy, especially those with higher fiber, fats and protein like pistachios. Daily portions can lower risk of heart disease more than 20% and diabetes almost 40%. Nuts like pistachios are filled with plant sterols, the same substances in cholesterol-lowering products that help block cholesterol absorption in your gut. 3. Green tea
[99] Dietary Influences on Atherosclerotic Cardiovascular Disease Risk — Purposeof Review Professional organizations recommend various healthy dietary patterns for atherosclerotic vascular disease (ASCVD) prevention. The purpose of this review is to discuss the evidence for the recommended healthy dietary patterns and ASCVD risk reduction, as well as briefly review specific areas of controversy. Recent Findings The Mediterranean, Dietary Approach to Stop
[124] [Genetic factors in the development of atherosclerosis] — Atherosclerosis is a complex multifactorial disease of the arterial wall, dependent on genetic disposition and multiple other risk factors. There are probably several candidate genes, that determine the individual susceptibility of the vessel wall to develop atherosclerosis. In recent years, a growi …
[125] Genetic and environmental risk factors for atherosclerosis regulate ... — Atherosclerosis involves the interplay of genetic factors with atherogenic stimuli, such as modified low-density lipoprotein, in cell types including macrophages, lymphocytes, endothelial cells and vascular smooth muscle cells , , , . The role of PHACTR1 in these cells and the mechanism whereby it alters CAD risk are unknown.
[126] Genetic Risk of Coronary Artery Disease, Features of Atherosclerosis ... — Coronary artery disease (CAD) is characterized by a substantial and complex polygenic contribution to disease risk. 1 Studies consistently show that ≈50% of the phenotypic variance in CAD may be explained by genetics (ie, heritability). 2, 3 Since 2007, genome‐wide association studies (GWASs) have identified a large number of common genetic variants associated with CAD. 4 Independently
[129] Advancements in the Treatment of Atherosclerosis: From Conventional ... — Atherosclerosis is a leading cause of morbidity and mortality worldwide, driven by a complex interplay of lipid dysregulation, inflammation, and vascular pathology. Despite advancements in understanding the multifactorial nature of atherosclerosis and improvements in clinical management, existing therapies often fall short in reversing the disease, focusing instead on symptom alleviation and
[132] Emerging Therapies for the Treatment of Atherosclerotic Cardiovascular ... — The largest gap in knowledge is in the treatment aspect, as we still cannot treat atherosclerosis with sufficient success, and this commonly limits us to the treatment of its consequences. According to leading experts in the field, we do possess the tools to mitigate atherosclerosis (through the targeting of very low lipid levels sufficiently
[137] Immunotherapy for atherosclerosis by targeting pro-inflammatory T cells — Atherosclerosis is a chronic inflammatory disease of the arteries that leads to major adverse cardiovascular events (MACEs) including ischemic heart disease and stroke.1 Despite advancements in lipid-lowering therapies, a significant residual risk of MACEs persists, underscoring the need for innovative treatment strategies.1 Recent research has shifted focus to the role of adaptive immunity in atherosclerosis, with T-cells emerging as pivotal players in disease progression.2,3,4 Immunotherapy has revolutionized oncology and is now set to bring its transformative potential to atherosclerosis management. For example, the CANTOS trial, which targeted inflammation with the interleukin-1β inhibitor canakinumab, marked a milestone in validating the inflammatory hypothesis of atherothrombosis.5 Tolerogenic and antibody-based vaccines to self-epitopes have shown promise in mouse experiments.6,7 Based on extensive preclinical data and emerging clinical insights, the recent study leveraging anti-PD-1 monoclonal antibodies suggest a potential new treatment paradigm in cardiovascular medicine.8 In tumor patients with existing atherosclerosis, anti-PD-1 monoclonal antibody therapy significantly reduced atherosclerotic plaque size.
[141] Immunotherapy for atherosclerosis by targeting pro-inflammatory T cells — Atherosclerosis is a chronic inflammatory disease of the arteries that leads to major adverse cardiovascular events (MACEs) including ischemic heart disease and stroke.1 Despite advancements in lipid-lowering therapies, a significant residual risk of MACEs persists, underscoring the need for innovative treatment strategies.1 Recent research has shifted focus to the role of adaptive immunity in atherosclerosis, with T-cells emerging as pivotal players in disease progression.2,3,4 Immunotherapy has revolutionized oncology and is now set to bring its transformative potential to atherosclerosis management. For example, the CANTOS trial, which targeted inflammation with the interleukin-1β inhibitor canakinumab, marked a milestone in validating the inflammatory hypothesis of atherothrombosis.5 Tolerogenic and antibody-based vaccines to self-epitopes have shown promise in mouse experiments.6,7 Based on extensive preclinical data and emerging clinical insights, the recent study leveraging anti-PD-1 monoclonal antibodies suggest a potential new treatment paradigm in cardiovascular medicine.8 In tumor patients with existing atherosclerosis, anti-PD-1 monoclonal antibody therapy significantly reduced atherosclerotic plaque size.
[142] Advancements in the Treatment of Atherosclerosis: From Conventional ... — These include new classes of lipid-regulating drugs, advanced anti-inflammatory agents, and cutting-edge strategies that leverage the body's immune response to combat plaque formation. The successful integration of these emerging research findings into clinical practice is vital for the evolution of atherosclerosis management.
[147] Recent advances in targeted stimuli-responsive nano-based drug delivery ... — Herein, we have systematically summarized the recent advances in stimuli-responsive nano-based drug delivery systems (NDDSs) for atherosclerosis (AS) treatments. Besides, we have also summarized in detail the classification of stimuli-responsive NDDSs for AS.
[170] Impact of Lifestyle Modifications on Cardiovascular Health: A Narrative ... — Keywords: cardiovascular disease, stress, healthy heart diet, physical activity, lifestyle modifications, cardiovascular health Dietary approaches: The American Heart Association (AHA) has recommended dietary approaches for cardiovascular health, including the combination of a heart-healthy diet (such as the Mediterranean or DASH diet) with reduced sodium intake, limited added sugars, and avoidance of trans fats. Obesity is a significant risk factor for CVDs, and losing excess weight or preventing weight gain through physical activity reduces the risk of developing cardiovascular conditions such as heart disease, stroke, and type 2 diabetes . Implementing healthy habits, such as regular physical activity, a balanced diet, smoking cessation, stress management, and adequate sleep, can significantly reduce the risk of CVDs and improve overall cardiovascular well-being.
[171] Atherosclerosis - Prevention - NHLBI, NIH — Atherosclerosis - Prevention | NHLBI, NIH Share sensitive information only on official, secure websites. MAIN MENU Heart-Healthy Living NHLBI News About NHLBI Home The best way to ensure heart health is to prevent risk factors from developing in the first place. Following the steps for heart-healthy living can help prevent or delay these risk factors. If lifestyle changes aren't enough to control your risk factors, talk with your healthcare provider about medicines. Taking early steps in childhood toward heart-healthy living and continuing through adulthood can prevent atherosclerosis and its complications. Self-Care Tips for Heart Health Learn about how and why to make heart health part of your self-care routine. Make an Appointment to Talk with Your Healthcare Provider About Heart Health!
[173] Practical, Evidence-Based Approaches to Nutritional Modifications to ... — Although often there is debate in popular media about which dietary pattern is best, the nutrition science is clear regarding which dietary patterns reduce risk for CVD: A diet consisting predominantly of fruits, vegetables, legumes, nuts, seeds, plant protein and fatty fish is optimal for the prevention of ASCVD (Central Figure).
[174] 15 Foods That May Help Prevent Clogged Arteries - Healthline — Eating foods like beets that are rich in dietary nitrates may help improve blood vessel function and decrease inflammation, which may help prevent atherosclerosis (21Trusted Source). Eating oats can help significantly reduce atherosclerosis risk factors, including high total and LDL (bad) cholesterol (24Trusted Source, 25Trusted Source). Research also suggests eating nuts and seeds reduces blood sugar levels and may help protect against diabetes, a known risk factor for atherosclerosis (26Trusted Source, 28Trusted Source). A 2018 review also concluded that olive oil consumption is associated with reduced atherosclerosis-related inflammatory markers and a decreased risk of heart disease and complications (37Trusted Source). On the other hand, following a diet rich in certain foods like vegetables, fruits, and fish has been shown to reduce the risk of atherosclerosis and heart disease (42Trusted Source).
[178] Heart Disease and Stroke Prevention: Interventions Engaging Community ... — Heart Disease and Stroke Prevention: Interventions Engaging Community Health Workers - Healthy People 2030 | odphp.health.gov U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion Use Healthy People 2030 Evidence-Based Resources in Your Work Health Equity in Healthy People 2030 Health Literacy in Healthy People 2030 Heart Disease and Stroke Prevention: Interventions Engaging Community Health Workers Heart Disease and Stroke Prevention: Interventions Engaging Community Health Workers The Community Preventive Services Task Force (CPSTF) recommends interventions that engage community health workers to prevent cardiovascular disease (CVD) for patients at an increased risk. Heart disease and stroke prevention: interventions engaging community health workers. Retrieved from https://www.thecommunityguide.org/findings/cardiovascular-disease-prevention-and-control-interventions-engaging-community-health The Office of Disease Prevention and Health Promotion (ODPHP) cannot attest to the accuracy of a non-federal website.
[179] Lifestyle Changes Can Help Your Atherosclerosis - Orlando Health — If you have atherosclerosis, the arteries in your body harden due to a buildup of cholesterol and fat, leading to strokes, heart attacks, amputation and even death. Surgery can lessen some of the acute damage, but lifestyle modifications are key to preventing other conditions from occurring. Sarah McLean PA-C at Orlando Health explains.
[180] Lifestyle factors as determinants of atherosclerotic cardiovascular ... — A sedentary lifestyle, low levels of physical activity and fitness, poor dietary patterns, and psychosocial stress are strongly associated with increased morbidity and mortality from atherosclerotic cardiovascular disease (ASCVD). Conversely, engaging in regular physical activity, maintaining optimal fitness levels, adhering to a heart-healthy dietary pattern, effectively managing body weight
[181] Lifestyle management to prevent atherosclerotic cardiovascular disease ... — Beneficial effects on major cardiovascular events of an energy-unrestricted Mediterranean diet, supplemented with olive oil or mixed nuts, were confirmed in the primary prevention PREDIMED study in patients at high risk for ASCVD events (29% lower risk of ASCVD over a 5-year period) . Indeed, regular physical activity prevents ischaemic heart disease , impacts favourably on numerous risk factors , and has a dose-response impact on ASCVD events, all-cause and cardiovascular mortality in the general population and in cardiac patients . Effect of a lifestyle intervention program with energy-restricted mediterranean diet and exercise on weight loss and cardiovascular risk factors: one-year results of the PREDIMED-plus trial.
[184] Dietary recommendations for prevention of atherosclerosis — Search: Search This review aims at summarizing updated evidence on cardiovascular disease (CVD) risk associated with consumption of specific food items to substantiate dietary strategies for atherosclerosis prevention. The evidence is highly concordant in showing that, for the healthy adult population, low consumption of salt and foods of animal origin, and increased intake of plant-based foods-whole grains, fruits, vegetables, legumes, and nuts-are linked with reduced atherosclerosis risk. This review provides evidence-based support for promoting appropriate food choices for atherosclerosis prevention in the general population. Keywords: Atherosclerosis; Cardiovascular disease; Coronary heart disease; Diet; Dietary recommendations; Food choices; Prevention. Dietary Patterns and Risk of Cardiovascular Disease: A Systematic Review [Internet]. Associations between microalbuminuria and animal foods, plant foods, and dietary patterns in the Multiethnic Study of Atherosclerosis.
[185] Exercise, Cardiovascular Health, and Risk Factors for Atherosclerosis ... — Physical activity and exercise are associated with improved cardiovascular health, especially with reduced blood pressure, and should be encouraged on the individual and population level. Evidence regarding its effects on blood lipids and flow-mediated dilatation still need solid landmark studies to guide clinical practice.
[190] Fiber: The carb you can count on for heart health — Even though fiber passes through our bodies without being digested, it provides many health benefits, particularly for the heart. Fiber-rich diets may reduce the risk of heart disease and stroke by as much as 30%, according to a review article in the February 2 issue of The Lancet.
[191] 10 Amazing Health Benefits of Fiber - EatingWell — 4. Lower Odds of Heart Disease . According to a 2022 BMC Public Health study, a higher fiber intake was associated with a reduced risk for cardiovascular disease (CVD) in a large group of Americans. Researchers don't completely understand how fiber works, but they think that soluble fiber plays a role in decreasing lipid uptake from the intestinal tract, resulting in lower blood levels of
[194] Are you getting enough omega-3 fatty acids? - American Heart Association — Omega-3 fatty acids play an important role in heart and brain health. They've been linked to a stronger immune system, reduced inflammation and lower blood pressure and triglycerides, reducing the risk for heart disease and cognitive decline. But most people in the U.S. don't include enough omega-3s in their diets.
[195] Role of omega-3 fatty acids in the prevention and treatment of ... — The 2022 AHA/American College of Cardiology (ACC)/Heart Failure Society of America (HFSA) Guideline for the Management of Heart Failure recommends omega-3 fatty acids for patients with heart failure (NYHA Class Ⅱ-Ⅳ) to reduce the risk of cardiovascular hospitalization and mortality (IIb, B), which is the first time that omega-3 fatty acids
[196] Omega-3 Fatty Acids & the Important Role They Play - Cleveland Clinic — Some foods that can help you add omega-3s to your diet include fatty fish (like salmon and mackerel), flaxseed and chia seeds. Omega-3 fatty acids may lower your cardiovascular disease risk when you consume them as part of your diet. The chart below lists some types of fish that can add omega-3 fatty acids to your diet. If you have heart disease or high triglyceride levels, you may benefit from consuming even more omega-3 fatty acids. Select patients may not get enough omega-3 from their diet, and therefore they may benefit from taking fish oil supplements. Talk to your healthcare provider if you have 3 grams or more of omega-3 fatty acids in your diet each day.
[210] A brief overview of currently used atherosclerosis treatment approaches ... — There are numerous strategies in the treatment and prevention of atherosclerosis, focusing on different aspects of the disease, such as inflammation, lipid metabolism alterations, or others, but none of them, unfortunately, is absolutely effective. In patients with coronary artery disease or atherosclerosis, the following peculiarities of lipid spectrum disturbances most often occur: total cholesterol is moderately elevated, LDL (low-density lipoprotein) cholesterol is elevated significantly . Groups of compounds normalizing lipid metabolism include: (1) inhibitors of the enzyme MMC-CoA reductase (statins); (2) bile acid sequestrants (resins); (3) derivatives of fibric acid (fibrates); (4) nicotinic acid (niacin, enduracin); (5) cholesterol absorption inhibitor in the intestine (ezetimibe); (6) PNZhS - ω-3 PUFA. doi: 10.1016/j.atherosclerosis.2010.05.034. doi: 10.1016/j.atherosclerosis.2010.03.011. doi: 10.1016/j.atherosclerosis.2013.02.021.
[212] Recent Advances in Coronary Artery Bypass Grafting Techniques and ... — We undertook a search through PubMed Central in March 2023 using keywords such as "coronary bypass," "percutaneous coronary intervention ... Genetic modification of grafts to enhance their patency and resistance to atherosclerosis. Improved graft integration, reduced re-stenosis rate. ... Recent advances in treatment of coronary artery disease
[213] Navigating Complex Femoropopliteal Atherosclerosis: A Surgeon's ... — The field of vascular surgery has witnessed remarkable advancements in recent years, revolutionizing the treatment of complex femoropopliteal atherosclerotic disease. I have witnessed firsthand the transformative impact of directional atherectomy (DA) and drug-coated balloon (DCB) angioplasty on
[214] Recent Advances in Coronary Artery Bypass Grafting Techniques and ... — Coronary artery bypass grafting (CABG) has witnessed remarkable progress in recent years, driven by innovative techniques and refined approaches that have transformed patient outcomes and treatment paradigms. ... Recent Advances in Coronary Artery Bypass Grafting Techniques and Outcomes: A Narrative Review Cureus. 2023 Sep 18;15(9): e45511
[215] Designing the coronary artery bypass surgery operation of the ... - PubMed — Purpose of review: This article discusses current shortcomings in coronary artery bypass surgery and ways to overcome them. Recent findings: Minimally invasive coronary bypass surgery, robotic coronary bypass, and hybrid approaches aim to avoid sternotomy, employ arterial grafts, and minimize the use of cardiopulmonary bypass. Other considerations such as bypass graft validation, the
[218] Effect of statins on atherosclerotic plaque - PubMed — Notably, statins play a role in plaque regression with reduction in lipid content. These drugs further stabilize atherosclerotic plaque with thickened fibrous caps and macrocalcification that serves to stabilize atheromas.
[219] Statin Safety and Associated Adverse Events: A Scientific Statement ... — One in 4 Americans >40 years of age takes a statin to reduce the risk of myocardial infarction, ischemic stroke, and other complications of atherosclerotic disease. The most effective statins produce a mean reduction in low-density lipoprotein cholesterol of 55% to 60% at the maximum dosage, and 6 of the 7 marketed statins are available in generic form, which makes them affordable for most
[220] Statins: pros and cons - PMC — As with all drugs, statins may have adverse effects; these include musculoskeletal symptoms, increased risk of diabetes, and higher rates of hemorrhagic stroke. However, the frequency of adverse effects is extremely low and, in selected patient populations, the benefits of statins considerably outweigh the potential risks.
[221] Adverse effects of statin therapy: perception vs. the evidence - focus ... — Conclusion Long-term statin treatment is remarkably safe with a low risk of clinically relevant adverse effects as defined above; statin-associated muscle symptoms were discussed in a previous Consensus Statement. Importantly, the established cardiovascular benefits of statin therapy far outweigh the risk of adverse effects.
[222] Medications for Lipid Control: Statins vs Newer Drugs - PubMed — The available statins are then reviewed, along with their main pharmacologic properties and potential adverse effects. Although statins are generally well tolerated, certain patients may require dose adjustments or alternative treatments because of side-effects.
[238] Understanding the molecular mechanisms of statin pleiotropic effects — Abstract. Statins represent the cornerstone of pharmacotherapy for the prevention of atherosclerotic cardiovascular disease. These medications not only reduce low-density lipoprotein cholesterol (LDL-C) via inhibition of 3-hydroxy-3-methylglutarate attached to CoA reductase, the key rate-limiting step in the cholesterol biosynthetic pathway, but also upregulate expression of the low-density
[239] PDF — Mechanisms for the action of statins Mechanisms involving lipids Dyslipidemia and hypercholesterolemia are controled by the liver. Hepatocytes take up from the circulation ~ 50% of LDL cholesterol. An increase in the activity of LDL receptor in hepatocytes could be an efficient method to decrease plasma LDL cholesterol level. Inhibition of HMG