Miażdżyca
Epidemiologia

Miażdżyca jest przewlekłym procesem zapalnym tętnic dużego i średniego kalibru, stanowiącym główną przyczynę chorób sercowo-naczyniowych, takich jak choroba niedokrwienna serca, udar mózgu i choroby naczyń obwodowych. Epidemiologicznie, choroby te odpowiadają za około 1/3 zgonów na świecie (17,9 mln w 2019 r.), z tendencją wzrostową liczby przypadków z 271 mln w 1990 r. do 523 mln w 2019 r. Czynniki ryzyka miażdżycy dzielą się na niemodyfikowalne (wiek, płeć, pochodzenie etniczne, czynniki genetyczne) oraz modyfikowalne, wśród których dominują dyslipidemia (zwłaszcza podwyższony LDL), nadciśnienie tętnicze, cukrzyca, palenie tytoniu, otyłość i brak aktywności fizycznej. Proces miażdżycowy rozpoczyna się już w dzieciństwie, a jego kliniczne manifestacje nasilają się z wiekiem, z wyraźnym wpływem hormonów płciowych na przebieg choroby. W diagnostyce coraz większe znaczenie zyskują metody obrazowe, takie jak tomografia komputerowa tętnic wieńcowych (CCTA) oraz ocena wapnia w tętnicach wieńcowych (CAC), które pozwalają na wczesne wykrycie i ocenę zaawansowania zmian miażdżycowych.

Epidemiologia miażdżycy

Miażdżyca (atherosclerosis) jest główną przyczyną chorób sercowo-naczyniowych na świecie. Jako proces patologiczny charakteryzujący się nagromadzeniem lipidów i elementów włóknistych w dużych i średnich tętnicach, miażdżyca stanowi podłoże dla chorób niedokrwiennych serca, udarów mózgu oraz chorób naczyń obwodowych.12 Choroba ta, początkowo przebiegająca bezobjawowo, jest głównym czynnikiem odpowiedzialnym za śmiertelność i chorobowość w krajach uprzemysłowionych, a jej rozpowszechnienie stale wzrasta.3

Rozpowszechnienie miażdżycy na świecie

Choroby sercowo-naczyniowe, których podstawą patofizjologiczną jest miażdżyca, stanowią wiodącą przyczynę zgonów na świecie. Według danych z 2019 roku, choroby sercowo-naczyniowe odpowiadały za około 1/3 wszystkich zgonów (17,9 miliona), z czego większość (85%) wynikała z choroby niedokrwiennej serca i udaru mózgu.4 W latach 1990-2019 globalna liczba przypadków chorób sercowo-naczyniowych prawie podwoiła się – z 271 milionów do 523 milionów.5

W Stanach Zjednoczonych co roku umiera około 610 000 osób z powodu chorób serca, co stanowi 1 na 4 zgony. Choroba wieńcowa jest wiodącą przyczyną śmierci w świecie zachodnim, zabijając ponad 370 000 osób rocznie.6 Szacuje się, że w USA około 1,5 miliona Amerykanów rocznie doświadcza ostrego zawału mięśnia sercowego, z czego jedna trzecia umiera. W 2009 roku około 785 000 Amerykanów doświadczyło pierwszego zawału serca, a około 470 000 miało nawracający incydent. Dodatkowo szacuje się, że co roku występuje około 195 000 „cichych” zawałów serca.7

Rozpowszechnienie miażdżycy jest trudne do dokładnego określenia, ponieważ jest to przeważnie stan bezobjawowy. Jednakże, badania epidemiologiczne wykazały, że ponad 50% osób z chorobami układu krążenia umiera z powodu miażdżycy, głównie w społeczeństwach rozwiniętych.8 W szwedzkim badaniu populacyjnym u osób w średnim wieku, którzy nie mieli wcześniej zawału mięśnia sercowego ani interwencji wieńcowej, badanie angiografii tomografii komputerowej wykazało, że 42,1% populacji miało blaszki miażdżycowe w tętnicach wieńcowych, podczas gdy znaczące zwężenie (≥50%) było mniej powszechne (u 5,2%).9

Różnice geograficzne i etniczne

Częstość występowania klinicznych objawów miażdżycy różni się istotnie pomiędzy regionami świata. W Wielkiej Brytanii, szczególnie na zachodzie Szkocji, oraz w Skandynawii, zwłaszcza w Finlandii, odnotowuje się szczególnie wysoką częstość występowania choroby wieńcowej. Rosja i wiele byłych państw Związku Radzieckiego doświadczyły w ostatnich latach wykładniczego wzrostu częstości występowania choroby wieńcowej, co prawdopodobnie wynika z powszechnych trudności gospodarczych, zaburzeń społecznych, wysokiej częstości palenia papierosów oraz diety bogatej w tłuszcze nasycone.10

Częstość występowania choroby wieńcowej na Dalekim Wschodzie jest znacznie niższa niż w krajach zachodnich. Mogą istnieć niezdefiniowane genetyczne przyczyny tego zjawiska, ale znaczne zainteresowanie budzi rola diety i innych czynników środowiskowych w braku klinicznych chorób naczyniowych na tle miażdżycowym w tych populacjach. Miażdżyca układu sercowo-naczyniowego jest również rzadka na kontynencie afrykańskim, chociaż coraz więcej dowodów wskazuje, że także to się zmienia w wyniku szybkiej westernizacji i urbanizacji tradycyjnie wiejskich i rolniczych populacji afrykańskich.11

Warto również zauważyć, że częstość występowania miażdżycy wewnątrzczaszkowej różni się znacząco w zależności od grupy etnicznej. Choroba ta jest ważną przyczyną udaru niedokrwiennego w niektórych grupach rasowych, szczególnie u Azjatów, ale także u Latynosów i osób czarnoskórych. Miażdżyca wewnątrzczaszkowa jest identyfikowana u do ~50% pacjentów azjatyckich z udarem niedokrwiennym. W populacjach białych jest to jednak rzadka przyczyna (około ~10%) udaru niedokrwiennego.12

Obserwuje się również zjawisko niższej częstości występowania chorób wieńcowych we Francji i regionie śródziemnomorskim, mimo spożywania bogatych pokarmów. Fenomen ten (czasami nazywany francuskim paradoksem) jest częściowo wyjaśniany większym spożyciem alkoholu, z jego możliwą korzyścią w podnoszeniu HDL, oraz spożyciem diety śródziemnomorskiej, która obejmuje przeważające użycie jednonienasyconych kwasów tłuszczowych, takich jak oliwa z oliwek lub olej rzepakowy, a także kwasów omega-3, które są mniej aterogenne.13

Zaawansowanie miażdżycy a wiek

Proces miażdżycowy rozpoczyna się w dzieciństwie od rozwoju tzw. „fatty streaks” (pasm tłuszczowych). Zmiany te można znaleźć w aorcie wkrótce po urodzeniu, a pojawiają się w coraz większej liczbie u osób w wieku 8-18 lat.14 Badania epidemiologiczne w Stanach Zjednoczonych wykazały obecność pasm tłuszczowych w aorcie u większości dzieci powyżej 3 roku życia.15

Pierwsze dowody na wczesne początki miażdżycy pochodzą z badania autopsyjnego przeprowadzonego na amerykańskich żołnierzach zabitych podczas wojny w Korei, w którym przeprowadzono 300 autopsji. Pomimo średniego wieku żołnierzy wynoszącego zaledwie 22 lata, 77% z nich miało widoczne oznaki miażdżycy tętnic wieńcowych.16

Badania kliniczne i morfologiczne wykazały, że proces miażdżycowy rozpoczyna się już w łonie matki poprzez zwiększenie grubości błony wewnętrznej i środkowej tętnicy szyjnej u płodów i niemowląt, co znacznie zwiększa częstość występowania i progresję procesu miażdżycowego u dzieci i młodzieży.17 W raporcie z 1992 roku wykazano, że mikroskopijne pasma tłuszczowe były widoczne w lewej tętnicy zstępującej przedniej u ponad 50% dzieci w wieku 10-14 lat, a 8% miało jeszcze bardziej zaawansowane zmiany z większą akumulacją lipidów pozakomórkowych.18

Bardziej zaawansowane zmiany zaczynają się rozwijać, gdy osoby osiągają wiek około 25 lat. Następnie obserwuje się coraz większą częstość występowania zaawansowanych, powikłanych zmian miażdżycowych, a specyficzne dla narządów kliniczne manifestacje choroby zwiększają się z wiekiem przez piątą i szóstą dekadę życia.19

Różnice między płciami

Mężczyźni częściej rozwijają miażdżycę niż kobiety, a powikłania ogólnie pojawiają się u nich w młodszym wieku.20 Jest to częściowo związane z ochronnym działaniem estrogenów u kobiet przed menopauzą. Częstość występowania pęknięć blaszek miażdżycowych różni się w zależności od dekady życia, przy czym najwyższa częstość pęknięć blaszek występuje u mężczyzn w wieku 40 lat, podczas gdy u kobiet częstość ta wzrasta po 50 roku życia.21

Około 80% zakrzepów wieńcowych u kobiet powyżej 50 roku życia powstaje w wyniku pęknięcia blaszki miażdżycowej, przy czym istnieje silny związek z krążącym cholesterolem. W ostrym zawale mięśnia sercowego lub nagłej śmierci wieńcowej, erozja blaszki występuje głównie u pacjentów poniżej 50 roku życia i stanowi większość ostrych zakrzepów wieńcowych u kobiet przed menopauzą.22

Czynniki ryzyka miażdżycy

Liczne badania epidemiologiczne w Ameryce Północnej i Europie zidentyfikowały szereg czynników ryzyka rozwoju i progresji miażdżycy. Mogą one promować miażdżycę poprzez wpływ na cząsteczki lipoprotein o niskiej gęstości (LDL) i stan zapalny.23

Czynniki ryzyka niemodyfikowalne

Do niemodyfikowalnych czynników ryzyka miażdżycy należą:2425

  • Wiek – częstość występowania miażdżycy zwiększa się wraz z wiekiem, a młode dzieci z dowodami pasm tłuszczowych bardzo prawdopodobnie rozwiną chorobę w starszym wieku.26
  • Płeć – mężczyźni rozwijają miażdżycę częściej niż kobiety, a powikłania pojawiają się wcześniej.27
  • Pochodzenie etniczne – różne grupy etniczne mają różne ryzyko rozwoju miażdżycy.28
  • Czynniki genetyczne – historia rodzinna wczesnej choroby serca lub udaru oraz zmiany w genach, które zwiększają prawdopodobieństwo miażdżycy.29

Amerykanie pochodzenia afrykańskiego wydają się mieć wyższe wskaźniki zachorowalności i śmiertelności z powodu choroby wieńcowej, nawet gdy statystyki są skorygowane o status edukacyjny i socjoekonomiczny. Profil czynników ryzyka u Amerykanów pochodzenia afrykańskiego różni się od tego u Amerykanów pochodzenia kaukaskiego. Częstość występowania nadciśnienia, otyłości, zespołu metabolicznego i braku aktywności fizycznej jest znacznie wyższa u Amerykanów pochodzenia afrykańskiego, podczas gdy częstość występowania hipercholesterolemii jest niższa.30

Czynniki ryzyka modyfikowalne

Główne modyfikowalne czynniki ryzyka miażdżycy obejmują:313233

  • Dyslipidemia – zaburzenia lipidowe, szczególnie podwyższony poziom cholesterolu LDL, stanowią główny czynnik ryzyka miażdżycy. Rozwój zmian miażdżycowych prawdopodobnie wymaga lipoprotein o niskiej gęstości – cząstek, które przenoszą cholesterol przez krew.34 Obserwacje epidemiologiczne wykazały, że pacjenci z wysokim stężeniem cholesterolu i lipoprotein w surowicy mają wyższą częstość występowania miażdżycy.35
  • Nadciśnienie tętnicze – nadciśnienie systemowe jest dobrze ugruntowanym głównym czynnikiem ryzyka śmiertelności i zachorowalności sercowo-naczyniowej w populacji ogólnej, będąc bardziej powszechnym niż palenie papierosów, dyslipidemia i cukrzyca. Badanie INTERHEART wykazało, że nadciśnienie odpowiadało za 18% ryzyka pierwszego zawału mięśnia sercowego.36
  • Cukrzyca – cukrzyca powoduje dysfunkcję śródbłonka, zmniejsza oporność śródbłonka na zakrzepy i zwiększa aktywność płytek krwi, przyspieszając miażdżycę.37 Częstość występowania choroby miażdżycowej i jej powikłań u pacjentów z cukrzycą typu 1 lub typu 2 jest znacznie wyższa niż u zdrowych osób.38 Wraz ze wzrostem częstości występowania cukrzycy wśród pacjentów z chorobą wieńcową i lepszą kontrolą innych czynników ryzyka, takich jak palenie tytoniu i hipercholesterolemia, cukrzyca prawdopodobnie stanie się dominującym czynnikiem ryzyka miażdżycy.39
  • Palenie tytoniu – palenie może zwiększyć ryzyko rozwoju miażdżycy i jej powikłań, przy czym jedna paczka papierosów dziennie podwaja ryzyko, a dwie paczki dziennie potrajają je.40
  • Otyłość – jest znaczącym czynnikiem ryzyka miażdżycy.4142
  • Brak aktywności fizycznej – siedzący tryb życia zwiększa ryzyko miażdżycy.4344

Istnieją również coraz liczniejsze dowody wskazujące na rolę układu odpornościowego, a pojawiające się czynniki ryzyka obejmują stan zapalny i klonalną hematopoezę.45 Obecnie jest jasne, że ogólnoustrojowe i lokalne zdarzenia zapalne pośredniczą w tworzeniu, progresji i degeneracji blaszki miażdżycowej: miażdżyca jest przewlekłą chorobą zapalną.46

Nowe markery ryzyka miażdżycy

Ustalone czynniki ryzyka skutecznie przewidują przyszłe zdarzenia sercowe u około 50-60% pacjentów. Podejmowane są skoordynowane wysiłki w celu identyfikacji i walidacji nowych markerów przyszłego ryzyka klinicznych konsekwencji miażdżycy.47

Badania wykazały, że liczba neutrofili jest związana z tworzeniem blaszki miażdżycowej i chorobami sercowo-naczyniowymi. W badaniu przeprowadzonym w populacji tajwańskiej wykazano, że wyższa liczba neutrofili była niezależnie związana z występowaniem chorób sercowo-naczyniowych, z HR wynoszącym 1,42 (95% CI 1,03-1,94) po dostosowaniu do wielu współzmiennych.48

Wapń w tętnicach wieńcowych (CAC) wykazał związek z ryzykiem choroby wieńcowej. W blaszce miażdżycowej wapń jest często pofragmentowany i może znajdować się głęboko w blaszce lub blisko powierzchni.4950

Przegląd badań epidemiologicznych nad miażdżycą

Kluczowe badania populacyjne

Jednym z najważniejszych badań epidemiologicznych dotyczących miażdżycy jest Atherosclerosis Risk in Communities (ARIC) Study. Jest to prospektywne badanie epidemiologiczne prowadzone w czterech społecznościach USA: Forsyth County (Karolina Północna), Jackson (Mississippi), Minneapolis (Minnesota) i Washington County (Maryland). ARIC składa się z dwóch części: komponentu kohortowego i komponentu nadzoru społeczności.5152

Komponent nadzoru społeczności obejmuje około 470 000 mężczyzn i kobiet w wieku od 35 do 84 lat. Dane zbierano na temat zgonów z powodu choroby sercowo-naczyniowej (CHD) i niewydolności serca (HF) wśród uczestników w wieku od 35 do 74 lat, którzy zostali zakwalifikowani do badania w latach 1987-2014, oraz wśród uczestników w wieku od 35 do 84 lat w latach 2005-2014. W latach 2005-2014 badanie gromadziło również informacje na temat szpitalnej niewydolności serca wśród dorosłych w wieku 55 lat i starszych oraz ambulatoryjnej niewydolności serca u dorosłych w wieku 65 lat i starszych.53

Innym ważnym badaniem jest Multi-Ethnic Study of Atherosclerosis and Air Pollution (MESA Air). Jest to wieloośrodkowe prospektywne badanie kohortowe w USA, z szczegółowym szacowaniem ekspozycji na zanieczyszczenia powietrza na poziomie indywidualnym, oceną zdrowia i współzmiennych w wieloetnicznej kohorcie, rozpoczęte w 2004 roku. Projekt MESA Air, finansowany przez EPA, pozwoli na prospektywną ocenę, czy zanieczyszczenie powietrza przyspiesza miażdżycę i występowanie klinicznych chorób sercowo-naczyniowych.54

Badania przekrojowe i autopsyjne

W badaniu przekrojowym przeprowadzonym w Szwecji na dużej, losowej próbie populacji w średnim wieku bez wcześniejszego zawału mięśnia sercowego lub interwencji wieńcowej, angiografia tomografii komputerowej tętnic wieńcowych (CCTA) wykazała, że 42,1% populacji miało blaszki miażdżycowe w tętnicach wieńcowych. Istotne zwężenie (≥50%) było mniej powszechne (u 5,2%), a cięższe formy miażdżycy tętnic wieńcowych, jak choroba trzech naczyń, były rzadko spotykane (tylko u 1,9%).55

W dużym badaniu populacyjnym przeprowadzonym w Szwecji, uczestnicy z cukrzycą (n=2282, 7,6%) lub stanem przedcukrzycowym (n=4804, 16,0%) mieli większe obciążenie blaszkami w tętnicach wieńcowych, większe zwężenie tętnic wieńcowych i wyższy wskaźnik CACS niż uczestnicy z prawidłowym poziomem glikemii (wszystkie, p0,01). Częstość występowania miażdżycy w tętnicach wieńcowych była wyższa u uczestników z wcześniej niewykrytą cukrzycą niż u osób ze stanem przedcukrzycowym, ale niższa niż u pacjentów z rozpoznaną cukrzycą.56

Badania autopsyjne dostarczyły cennych informacji na temat wczesnego rozwoju miażdżycy. Oprócz wspomnianego już badania na amerykańskich żołnierzach z wojny koreańskiej, inne badania histopatologiczne również potwierdziły częste występowanie wczesnych zmian miażdżycowych już w młodym wieku.57 Badanie histologiczne seryjnie wyciętych tętnic wieńcowych od 13 mężczyzn i kobiet, którzy zmarli nagle i nieoczekiwanie, ujawniło częste występowanie wczesnych zmian miażdżycowych.58

Tendencje epidemiologiczne i prognozy

Zmiany trendów w czasie

W ciągu ostatnich kilku dekad śmiertelność sercowo-naczyniowa, częstość występowania zawału mięśnia sercowego i udaru mózgu oraz nasilenie miażdżycy tętnic wieńcowych znacznie się zmniejszyły, zmieniając prognostyczny i diagnostyczny krajobraz pacjentów z podejrzeniem lub potwierdzoną chorobą wieńcową.59 Obserwowany spadek zdarzeń sercowo-naczyniowych w populacji ogólnej został zarejestrowany niemal powszechnie i dotyczy wszystkich najczęstszych powikłań chorób naczyniowych na tle miażdżycowym.60

Warto jednak zauważyć, że mimo tych pozytywnych trendów w krajach rozwiniętych, w latach 1995-2005 wskaźnik zgonów z powodu choroby wieńcowej zmniejszył się o 34,3%, ale rzeczywista liczba zgonów zmniejszyła się tylko o 19,4%.61 Ponadto obserwuje się alarmujący wzrost miażdżycy w Azji Wschodniej, gdzie w ciągu ostatniej dekady odnotowano wzrost o 117,2% całkowitej liczby zgonów i 115,3% lat życia skorygowanych niepełnosprawnością.62

Prognozy na przyszłość

Pomimo postępów w leczeniu medycznym, interwencyjnym i chirurgicznym, miażdżyca pozostaje najważniejszą przyczyną śmierci zarówno w krajach rozwiniętych, jak i rozwijających się.63 Globalna liczba chorób sercowo-naczyniowych niemal podwoiła się z 271 milionów w 1990 roku do 523 milionów w 2019 roku, a liczba zgonów z powodu chorób sercowo-naczyniowych stale rosła z 12,1 miliona w 1990 roku, osiągając 18,6 miliona w 2019 roku. Do 2030 roku przewiduje się, że około 23,6 miliona osób umrze rocznie z powodu chorób sercowo-naczyniowych.64

Ogromne i wciąż rosnące obciążenie chorobami sercowo-naczyniowymi dla jednostek, rodzin i systemów opieki zdrowotnej wskazuje na pilną potrzebę środków zapobiegawczych i leczniczych w zakresie chorób miażdżycowych.65 Starzenie się społeczeństwa, urbanizacja i wzrost dobrobytu mogą służyć jako podstawowe kluczowe czynniki napędzające.66

Obciążenie ekonomiczne

Ekonomiczny wpływ chorób miażdżycowych jest ogromny.67 W Stanach Zjednoczonych około 14 milionów osób doświadcza choroby wieńcowej i jej różnych powikłań. Niewydolność serca (CHF), która rozwija się z powodu kardiomiopatii niedokrwiennej u pacjentów z nadciśnieniem po zawale mięśnia sercowego, stała się najczęstszym rozpoznaniem przy wypisie ze szpitali amerykańskich. Około 80 milionów ludzi, czyli 36,3% populacji, cierpi na choroby układu krążenia.68

Miażdżyca i choroba wieńcowa stanowią ogromne obawy zdrowotne na całym świecie. Stanowią one największą pojedynczą przyczynę śmierci i nakładają obciążenie finansowe wynoszące miliardy dolarów rocznie.69

Znaczenie dla zdrowia publicznego

Wyzwania i strategie prewencyjne

Istnieje kilka wyzwań w zakresie zapobiegania i leczenia miażdżycy, w tym: 1) wczesne wykrywanie uczestników z wysokim ryzykiem chorób sercowo-naczyniowych; 2) identyfikacja nowych wskaźników progresji i prognozy chorób miażdżycowych; 3) choroby współistniejące z chorobami miażdżycowymi; 4) nowe leki i terapie na miażdżycę i choroby sercowo-naczyniowe.70

Przytłaczające dowody sugerują, że regularna aktywność fizyczna (30 min/dzień), zaprzestanie palenia papierosów oraz spożywanie nutraceutyków przeciwutleniających bogatych w flawonoidy i retinoidy, świeżych warzyw i owoców, omega-3 PUFA, przypraw kulinarnych, probiotyków, diety śródziemnomorskiej i diety DASH obniżają ryzyko aterogenezy i chorób sercowo-naczyniowych.71

Nowe środki zapobiegawcze i alternatywne terapie, w tym interwencje dietetyczne i żywność pochodzenia roślinnego, mogą być najbardziej opłacalnymi sposobami zarządzania miażdżycą i chorobami sercowo-naczyniowymi.72 Zapobieganie ciężkiej progresji miażdżycy ma zmniejszyć wysoki wskaźnik zdarzeń sercowo-naczyniowych.73

Tendencje w badaniach naukowych

Badania epidemiologiczne nad miażdżycą przechodzą dynamiczne zmiany. Coraz większa uwaga kierowana jest na wykrywanie miażdżycy tętnic wieńcowych.74 Zobrazowanie obecności, rozległości, nasilenia i jakości miażdżycy tętnic wieńcowych wydaje się być głównym celem diagnostycznym współczesnego obrazowania u pacjentów z podejrzeniem lub potwierdzoną chorobą wieńcową lub niedokrwienną chorobą serca.75

Szybko przyspieszająca wiedza i kontynuowane badania obiecują dalszy postęp w zwalczaniu tej powszechnej choroby przewlekłej.76 Szeroka gama technik diagnostycznych, zarówno inwazyjnych (takich jak selektywna arteriografia wieńcowa), jak i nieinwazyjnych (takich jak biomarkery krwi, testy wysiłkowe, tomografia komputerowa i skanowanie jądrowe), pozwala na ocenę ryzyka chorób sercowo-naczyniowych i ukierunkowanie terapii.77

Niedawne badania nad wpływem zanieczyszczenia powietrza na miażdżycę dostarczyły nowych informacji. Badacze badali ekspozycję na drobne cząstki pyłu (PM2.5) i bliskość zamieszkania do głównych dróg w odniesieniu do zwapnienia aorty brzusznej, wrażliwego wskaźnika miażdżycy systemowej. Chociaż nie znaleziono przekonujących związków w całej badanej populacji, związki były silniejsze wśród uczestników z mniejszą błędną klasyfikacją ekspozycji. Wyniki te potwierdzają hipotezę związku między zanieczyszczeniem powietrza cząstkami stałymi a miażdżycą systemową.78

Ponadto, badania nad biologią miażdżycy wskazują na nowe potencjalne cele terapeutyczne. Badacze odkryli, że śródbłonkowy AGO1 promuje stan zapalny naczyń i dysfunkcję wątroby poprzez niekanoniczny mechanizm jako koaktywator NF-κB. Jego hamowanie zapewnia podwójne korzyści – łagodzenie dysregulacji lipidów i tłumienie stanu zapalnego naczyń – podkreślając EC-AGO1 jako obiecujący cel terapeutyczny dla miażdżycy i chorób kardiometabolicznych.79

Kolejne rozdziały

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Wybierz kolejny rozdział z menu poniżej, aby otworzyć nową podstronę kompedium wiedzy i uzyskać szczegółowe informację o leku, substancji lub chorobie.

  1. 09.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Atherosclerosis – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK507799/
    Atherosclerosis is considered the major cause of cardiovascular diseases. Atherosclerotic cardiovascular disease mainly involves the heart and brain: ischemic heart disease (IHD) and ischemic stroke. IHD and stroke are the world’s first and fifth causes of death respectively. […] In the United States, about 610,000 people die of heart disease every year. That is 1 of every 4 deaths. Coronary heart disease is the leading cause of death in the Western world killing over 370,000 people annually. […] Many epidemiologic studies in North America and Europe have recognized numerous risk factors for the development and progression of atherosclerosis. They may promote atherosclerosis through their effects on low-density lipoprotein (LDL) particles and inflammation.
  • #2 Atherosclerosis: Epidemiology and Pathophysiology | Thoracic Key
    https://thoracickey.com/atherosclerosis-epidemiology-and-pathophysiology/
    Atherosclerosis, a progressive disease characterized by the accumulation of lipids and fibrous elements in the large arteries, is the leading cause of death and disability in the United States and other industrialized nations (1). Cardiovascular atherosclerotic disease with its resultant ischemic heart disease, stroke, and peripheral vascular disease is responsible for approximately 50% of all deaths in the United States (2,3). […] The prevalence of atherosclerotic disease far exceeds the incidence of its adverse events. This raises a concern that with the aging population, atherosclerotic disease will become more manifest. […] Despite this, the prevalence of atherosclerotic disease continues to rise, and its resultant events continue to burden the health care system. […] Recent advances in our understanding of the fundamental cellular and molecular pathways involved have established an essential role for inflammation, vessel wall injury, and angiogenesis in the various stages of atherosclerosis.
  • #3 Atherosclerosis from Newborn to Adult-Epidemiology, Pathological Aspects, and Risk Factors – PubMed
    https://pubmed.ncbi.nlm.nih.gov/37895437/
    Cardiovascular disease is the leading cause of mortality and morbidity throughout the world, accounting for 16.7 million deaths each year. The underlying pathological process for the majority of cardiovascular diseases is atherosclerosis, a slowly progressing, multifocal, chronic, immune-inflammatory disease that involves the intima of large and medium-sized arteries. […] The prevalence of atherosclerosis is increasing worldwide and more than 50% of people with circulatory disease die of it, mostly in modern societies. Epidemiological studies have revealed several environmental and genetic risk factors that are associated with the early formation of a pathogenic foundation for atherosclerosis, such as dyslipidemia, hypertension, diabetes mellitus, obesity, and smoking. […] The purpose of this review is to bring together the current information concerning the origin and progression of atherosclerosis in childhood as well as the identification of known risk factors for atherosclerotic cardiovascular disease in children.
  • #4 Risk Factors and Epidemiology of Atherosclerosis – Pathology
    https://pressbooks.bccampus.ca/pathology/chapter/risk-factors-and-epidemiology-of-atherosclerosis/
    The latest 2021 World Health Organization report that analyzed epidemiological data from 2019, stated that cardiovascular disease (ischemic heart disease, stroke, peripheral artery disease, etc) remains the leading cause of death globally. […] Cardiovascular disease rates and prevalence vary between countries and reflect access to healthcare, presence of national prevention programs, prevalence of risk factors, and general aging and growth of the human population. […] Strikingly, 3/4 of acute cardiovascular events occur in low- and middle-income countries these days. […] In 2019, cardiovascular disease accounted for 1/3 (17.9 million) deaths in the world, with the majority of them (85%) resulting from ischemic heart disease and stroke. […] The most common underlying reason of this blood flow restriction is atherosclerosis.
  • #5 Epidemiology and Clinical Researches in Atherosclerosis and Cardiovascular Disease | Frontiers Research Topic
    https://www.frontiersin.org/research-topics/40371/epidemiology-and-clinical-researches-in-atherosclerosis-and-cardiovascular-disease/magazine
    Atherosclerosis is a systemic disease and the common cause of heart attacks, strokes and peripheral vascular disease collectively referred to as cardiovascular diseases (CVD), which are the leading cause of global mortality and a major contributor to disability and rising health care costs. The global number of total CVD nearly doubled from 271 million in 1990 to 523 million in 2019, and the number of CVD deaths steadily increased from 12.1 million in 1990, reaching 18.6 million in 2019. By 2030, approximately 23.6 million people are predicted to die from CVD annually. The huge and still growing burden of CVD on individuals, families, and health-care systems indicates an urgent need for prevention and treatment measures on atherosclerotic diseases. Preventing severe atherosclerosis progression is expected to decrease high cardiovascular event rate. However, there still exist challenges to be addressed. These challenges include but are not limited to 1) early detect participants with high-risk of CVD; 2) identify novel indicators for progression and prognosis of atherosclerotic diseases; 3) comorbidities of atherosclerotic diseases; 4) new drugs and therapies on atherosclerosis and CVD.
  • #6 Atherosclerosis – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK507799/
    Atherosclerosis is considered the major cause of cardiovascular diseases. Atherosclerotic cardiovascular disease mainly involves the heart and brain: ischemic heart disease (IHD) and ischemic stroke. IHD and stroke are the world’s first and fifth causes of death respectively. […] In the United States, about 610,000 people die of heart disease every year. That is 1 of every 4 deaths. Coronary heart disease is the leading cause of death in the Western world killing over 370,000 people annually. […] Many epidemiologic studies in North America and Europe have recognized numerous risk factors for the development and progression of atherosclerosis. They may promote atherosclerosis through their effects on low-density lipoprotein (LDL) particles and inflammation.
  • #7 Coronary Artery Atherosclerosis: Practice Essentials, Background, Anatomy
    https://emedicine.medscape.com/article/153647-overview
    Annually, approximately 1.5 million Americans have an AMI, a third of whom die. In 2009, 785,000 Americans were estimated to have suffered a first MI, and about 470,000 Americans were estimated to have had a recurrent event. An additional 195,000 „silent” heart attacks are estimated to occur each year. About every 34 seconds, an American will have an MI. CAD remains the number 1 cause of death for men and women in the United States and is responsible for approximately 20% of all US deaths. From 1995-2005, the death rate from CAD declined 34.3%, but the actual number of deaths declined only 19.4%. […] The international incidence of ACS and AMI, especially in developed countries, is similar to that observed in the United States. Despite consumption of rich foods, inhabitants of France and the Mediterranean region appear to have a lower incidence of CAD. This phenomenon (sometimes called the French paradox) is partly explained by greater use of alcohol, with its possible HDL-raising benefit, and by consumption of the Mediterranean diet, which includes predominant use of monounsaturated fatty acids, such as olive oil or canola oil, as well as omega-3 fatty acids, which are less atherogenic.
  • #8 Atherosclerosis from Newborn to Adult-Epidemiology, Pathological Aspects, and Risk Factors – PubMed
    https://pubmed.ncbi.nlm.nih.gov/37895437/
    Cardiovascular disease is the leading cause of mortality and morbidity throughout the world, accounting for 16.7 million deaths each year. The underlying pathological process for the majority of cardiovascular diseases is atherosclerosis, a slowly progressing, multifocal, chronic, immune-inflammatory disease that involves the intima of large and medium-sized arteries. […] The prevalence of atherosclerosis is increasing worldwide and more than 50% of people with circulatory disease die of it, mostly in modern societies. Epidemiological studies have revealed several environmental and genetic risk factors that are associated with the early formation of a pathogenic foundation for atherosclerosis, such as dyslipidemia, hypertension, diabetes mellitus, obesity, and smoking. […] The purpose of this review is to bring together the current information concerning the origin and progression of atherosclerosis in childhood as well as the identification of known risk factors for atherosclerotic cardiovascular disease in children.
  • #9 Atherosclerosis, Diabetes Mellitus, and Cancer: Common Epidemiology, Shared Mechanisms, and Future Management
    https://www.mdpi.com/1422-0067/24/14/11786
    Atherosclerosis eventually leads to cardiovascular disease (ASCVD), a leading cause of global morbidity and mortality because of potentially hazardous complications, i.e., acute myocardial infarction (MI), stroke, and ischemic cardiomyopathy. Estimated ASCVD-attributed deaths are near the top, accounting for one-third of all deaths. Silent coronary atherosclerosis without an established disease is common in the general population, as shown in a large, random sample of a middle-aged population from Sweden without previous myocardial infarction or coronary intervention, where coronary computed tomography angiography (CCTA) showed that 42.1% of the population had plaques in their coronary arteries. Significant stenosis (≥50%) was less common (in 5.2%), and more severe forms of coronary atherosclerosis, like three-vessel disease, were rarely found (in only 1.9%). The prevalence of CCTA-detected coronary atherosclerosis in this study closely reflects the incidence of ASCVD in many other Western countries.
  • #10 Coronary Artery Atherosclerosis: Practice Essentials, Background, Anatomy
    https://emedicine.medscape.com/article/153647-overview
    The frequency of clinical manifestations of atherosclerosis in Great Britain, west of Scotland in particular, is especially high. The same is true of Scandinavia in general and of Finland in particular. Russia and many of the former states of the Soviet Union have recently experienced an exponential increase in the frequency of coronary heart disease that likely is the result of widespread economic hardship and social upheaval, a high prevalence of cigarette habituation, and a diet high in saturated fats. […] The frequency of coronary heart disease in the Far East is significantly lower than that documented in the West. Ill-defined genetic reasons for this phenomenon may exist, but significant interest surrounds the role of diet and other environmental factors in the absence of clinical atherosclerotic vascular disease in these populations. Atherosclerotic cardiovascular disease is also rare on the African continent, although growing evidence indicates that this too is changing, as a result of rapid westernization and urbanization of the traditionally rural and agrarian African populations. The prevalence of coronary heart disease is also increasing in the Middle East, India, and Central and South America.
  • #11 Coronary Artery Atherosclerosis: Practice Essentials, Background, Anatomy
    https://emedicine.medscape.com/article/153647-overview
    The frequency of clinical manifestations of atherosclerosis in Great Britain, west of Scotland in particular, is especially high. The same is true of Scandinavia in general and of Finland in particular. Russia and many of the former states of the Soviet Union have recently experienced an exponential increase in the frequency of coronary heart disease that likely is the result of widespread economic hardship and social upheaval, a high prevalence of cigarette habituation, and a diet high in saturated fats. […] The frequency of coronary heart disease in the Far East is significantly lower than that documented in the West. Ill-defined genetic reasons for this phenomenon may exist, but significant interest surrounds the role of diet and other environmental factors in the absence of clinical atherosclerotic vascular disease in these populations. Atherosclerotic cardiovascular disease is also rare on the African continent, although growing evidence indicates that this too is changing, as a result of rapid westernization and urbanization of the traditionally rural and agrarian African populations. The prevalence of coronary heart disease is also increasing in the Middle East, India, and Central and South America.
  • #12 Intracranial atherosclerotic disease | Radiology Reference Article | Radiopaedia.org
    https://radiopaedia.org/articles/intracranial-atherosclerotic-disease?lang=us
    Intracranial atherosclerotic disease is an important cause of ischemic stroke in certain racial groups, particularly Asians, but also Hispanics and Black populations. Intracranial atherosclerotic disease is identified in up to ~50% of Asian patients with ischemic stroke. In White populations, however, intracranial atherosclerotic disease is an uncommon cause (approximately ~10%) of ischemic stroke. […] The rate of ischemic stroke recurrence in patients with intracranial atherosclerotic disease may be up to ~30% within two years.
  • #13 Coronary Artery Atherosclerosis: Practice Essentials, Background, Anatomy
    https://emedicine.medscape.com/article/153647-overview
    Annually, approximately 1.5 million Americans have an AMI, a third of whom die. In 2009, 785,000 Americans were estimated to have suffered a first MI, and about 470,000 Americans were estimated to have had a recurrent event. An additional 195,000 „silent” heart attacks are estimated to occur each year. About every 34 seconds, an American will have an MI. CAD remains the number 1 cause of death for men and women in the United States and is responsible for approximately 20% of all US deaths. From 1995-2005, the death rate from CAD declined 34.3%, but the actual number of deaths declined only 19.4%. […] The international incidence of ACS and AMI, especially in developed countries, is similar to that observed in the United States. Despite consumption of rich foods, inhabitants of France and the Mediterranean region appear to have a lower incidence of CAD. This phenomenon (sometimes called the French paradox) is partly explained by greater use of alcohol, with its possible HDL-raising benefit, and by consumption of the Mediterranean diet, which includes predominant use of monounsaturated fatty acids, such as olive oil or canola oil, as well as omega-3 fatty acids, which are less atherogenic.
  • #14 Coronary Artery Atherosclerosis: Practice Essentials, Background, Anatomy
    https://emedicine.medscape.com/article/153647-overview
    The true frequency of atherosclerosis is difficult, if not impossible, to accurately determine because it is a predominantly asymptomatic condition. The process of atherosclerosis begins in childhood with the development of fatty streaks. These lesions can be found in the aorta shortly after birth and appear in increasing numbers in those aged 8-18 years. More advanced lesions begin to develop when individuals are aged approximately 25 years. Subsequently, an increasing prevalence of the advanced complicated lesions of atherosclerosis is noted, and the organ-specific clinical manifestations of the disease increase with age through the fifth and sixth decades of life. […] In the United States, approximately 14 million persons experience CAD and its various complications. Congestive heart failure (CHF) that develops because of ischemic cardiomyopathy in hypertensive MI survivors has become the most common discharge diagnosis for patients in American hospitals. Approximately 80 million people, or 36.3% of the population, have cardiovascular disease.
  • #15 Atherosclerosis from Newborn to Adult—Epidemiology, Pathological Aspects, and Risk Factors
    https://www.mdpi.com/2075-1729/13/10/2056
    Atherosclerosis, the main pathological process of most cardiovascular diseases, is predominantly an asymptomatic condition, and it is difficult to determine the incidence accurately. […] Epidemiological studies have revealed several environmental and genetic risk factors that are associated with the early formation of a pathogenic foundation for atherosclerosis, such as dyslipidemia, hypertension, diabetes mellitus, obesity, and smoking. […] Epidemiological, clinical, and morphological studies have shown that the atherosclerotic process begins in the womb by increasing carotid intima-media thickness in fetuses and infants, which significantly boosts the prevalence and progression of the atherosclerotic process in children and adolescents. […] The first evidence of the early origin of atherosclerosis was in an autopsy study performed on American soldiers killed in action in Korea, in which 300 autopsies were performed. […] Epidemiological studies in the United States of America reported aortic fatty streaks in most children over the age of 3.
  • #16 Atherosclerosis – Wikipedia
    https://en.wikipedia.org/wiki/Atherosclerosis
    Cardiovascular disease, which is predominantly the clinical manifestation of atherosclerosis, is one of the leading causes of death worldwide. […] Almost all children older than age 10 in developed countries have aortic fatty streaks, with coronary fatty streaks beginning in adolescence. […] In 1953, a study was published that examined the results of 300 autopsies performed on U.S. soldiers who had died in the Korean War. Despite the average age of the soldiers being just 22 years old, 77% of them had visible signs of coronary atherosclerosis. This study showed that heart disease could affect people at a younger age and was not just a problem for older individuals. […] In 1992, a report showed that microscopic fatty streaks were seen in the left anterior descending artery in over 50% of children aged 10-14 and 8% had even more advanced lesions with more accumulations of extracellular lipid. […] A 2005 report of a study done between 1985 and 1995 found that around 87% of aortas and 30% of coronary arteries in the age group 5-14 years had fatty streaks which increased with age.
  • #17 Atherosclerosis from Newborn to Adult—Epidemiology, Pathological Aspects, and Risk Factors
    https://www.mdpi.com/2075-1729/13/10/2056
    Atherosclerosis, the main pathological process of most cardiovascular diseases, is predominantly an asymptomatic condition, and it is difficult to determine the incidence accurately. […] Epidemiological studies have revealed several environmental and genetic risk factors that are associated with the early formation of a pathogenic foundation for atherosclerosis, such as dyslipidemia, hypertension, diabetes mellitus, obesity, and smoking. […] Epidemiological, clinical, and morphological studies have shown that the atherosclerotic process begins in the womb by increasing carotid intima-media thickness in fetuses and infants, which significantly boosts the prevalence and progression of the atherosclerotic process in children and adolescents. […] The first evidence of the early origin of atherosclerosis was in an autopsy study performed on American soldiers killed in action in Korea, in which 300 autopsies were performed. […] Epidemiological studies in the United States of America reported aortic fatty streaks in most children over the age of 3.
  • #18 Atherosclerosis – Wikipedia
    https://en.wikipedia.org/wiki/Atherosclerosis
    Cardiovascular disease, which is predominantly the clinical manifestation of atherosclerosis, is one of the leading causes of death worldwide. […] Almost all children older than age 10 in developed countries have aortic fatty streaks, with coronary fatty streaks beginning in adolescence. […] In 1953, a study was published that examined the results of 300 autopsies performed on U.S. soldiers who had died in the Korean War. Despite the average age of the soldiers being just 22 years old, 77% of them had visible signs of coronary atherosclerosis. This study showed that heart disease could affect people at a younger age and was not just a problem for older individuals. […] In 1992, a report showed that microscopic fatty streaks were seen in the left anterior descending artery in over 50% of children aged 10-14 and 8% had even more advanced lesions with more accumulations of extracellular lipid. […] A 2005 report of a study done between 1985 and 1995 found that around 87% of aortas and 30% of coronary arteries in the age group 5-14 years had fatty streaks which increased with age.
  • #19 Coronary Artery Atherosclerosis: Practice Essentials, Background, Anatomy
    https://emedicine.medscape.com/article/153647-overview
    The true frequency of atherosclerosis is difficult, if not impossible, to accurately determine because it is a predominantly asymptomatic condition. The process of atherosclerosis begins in childhood with the development of fatty streaks. These lesions can be found in the aorta shortly after birth and appear in increasing numbers in those aged 8-18 years. More advanced lesions begin to develop when individuals are aged approximately 25 years. Subsequently, an increasing prevalence of the advanced complicated lesions of atherosclerosis is noted, and the organ-specific clinical manifestations of the disease increase with age through the fifth and sixth decades of life. […] In the United States, approximately 14 million persons experience CAD and its various complications. Congestive heart failure (CHF) that develops because of ischemic cardiomyopathy in hypertensive MI survivors has become the most common discharge diagnosis for patients in American hospitals. Approximately 80 million people, or 36.3% of the population, have cardiovascular disease.
  • #20 Cardiovascular disease – Arterial Damage, Risk Factors, Prevention | Britannica
    https://www.britannica.com/science/cardiovascular-disease/Diseases-of-the-arteries
    Atherosclerosis, the most common form of arteriosclerosis, is a disease found in large and medium-sized arteries. It is characterized by the deposition of fatty substances, such as cholesterol, in the innermost layer of the artery (the intima). […] The six principal risk factors for atherosclerosis include age, genetics, gender, serum cholesterol concentrations, smoking, and diabetes. The prevalence of atherosclerosis increases with age, and young children with evidence of fatty streaks are very likely to develop the disease when they are older. […] Men develop atherosclerosis more often than women, and complications generally appear at an earlier age. […] Epidemiological observation has demonstrated that patients with high serum cholesterol and lipoprotein concentrations have a higher incidence of atherosclerosis.
  • #21 Atherosclerosis Pathology: Definition, Etiology, Epidemiology
    https://emedicine.medscape.com/article/1612610-overview
    Although lesions with rupture occur in males of all ages (this is consistent for all plaque morphologies with thrombi), the frequency of sudden coronary death decreases with advancing age. The incidence of rupture varies with each decade, and the highest incidence of plaque rupture is seen in the 40s in males, whereas in females the incidence increases beyond the age of 50 years. Approximately 80% of coronary thrombi in females older than 50 years occur from plaque rupture, and there is a strong association with circulating cholesterol. In acute MI or sudden coronary death, plaque erosion occurs primarily in patients younger than 50 years and represents the majority of acute coronary thrombi in premenopausal females. Furthermore, 20-25% of acute myocardial infarcts occurring in hospitalized patients are due to plaque erosion.
  • #22 Atherosclerosis Pathology: Definition, Etiology, Epidemiology
    https://emedicine.medscape.com/article/1612610-overview
    Although lesions with rupture occur in males of all ages (this is consistent for all plaque morphologies with thrombi), the frequency of sudden coronary death decreases with advancing age. The incidence of rupture varies with each decade, and the highest incidence of plaque rupture is seen in the 40s in males, whereas in females the incidence increases beyond the age of 50 years. Approximately 80% of coronary thrombi in females older than 50 years occur from plaque rupture, and there is a strong association with circulating cholesterol. In acute MI or sudden coronary death, plaque erosion occurs primarily in patients younger than 50 years and represents the majority of acute coronary thrombi in premenopausal females. Furthermore, 20-25% of acute myocardial infarcts occurring in hospitalized patients are due to plaque erosion.
  • #23 Atherosclerosis – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK507799/
    Atherosclerosis is considered the major cause of cardiovascular diseases. Atherosclerotic cardiovascular disease mainly involves the heart and brain: ischemic heart disease (IHD) and ischemic stroke. IHD and stroke are the world’s first and fifth causes of death respectively. […] In the United States, about 610,000 people die of heart disease every year. That is 1 of every 4 deaths. Coronary heart disease is the leading cause of death in the Western world killing over 370,000 people annually. […] Many epidemiologic studies in North America and Europe have recognized numerous risk factors for the development and progression of atherosclerosis. They may promote atherosclerosis through their effects on low-density lipoprotein (LDL) particles and inflammation.
  • #24 Risk Factors and Epidemiology of Atherosclerosis – Pathology
    https://pressbooks.bccampus.ca/pathology/chapter/risk-factors-and-epidemiology-of-atherosclerosis/
    Certain risk factors have been identified as associated with increased susceptibility to the development of atherosclerosis. […] Non-modifiable factors include: age, sex, ethnicity, and genetic factors. […] Even though non-modifiable risk factors cannot be changed, they should be considered as independent variables in atherosclerosis research. […] Epidemiological studies should represent the diversity of the global population, include young people, and account for socio-demographic factors (financial stability, employment status, mental health, stress levels). […] Atherosclerosis, a leading cause of mortality globally, remains a concern despite advancements in research and treatment approaches. […] Currently, the majority of cardiovascular deaths occur in low/middle-income countries, which highlights the importance of effective primary and secondary prevention strategies, access to healthcare, education, and other social determinants of health. […] Multiple risk factors have been identified as associated with atherosclerosis.
  • #25 Arteriosclerosis / atherosclerosis – Symptoms and causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/arteriosclerosis-atherosclerosis/symptoms-causes/syc-20350569
    Risk factors for atherosclerosis that you can’t control include: Aging. A family history of early heart disease or stroke. Changes in genes that make atherosclerosis more likely. Having inflammatory conditions such as lupus, inflammatory bowel disease or psoriasis. […] The complications of atherosclerosis depend on which arteries are narrowed or blocked. For example: Coronary artery disease. Atherosclerosis in the arteries close to the heart can lead to coronary artery disease. This may cause chest pain, a heart attack or heart failure. […] The same healthy lifestyle changes recommended to treat atherosclerosis also help prevent it. These lifestyle changes can help keep the arteries healthy.
  • #26 Cardiovascular disease – Arterial Damage, Risk Factors, Prevention | Britannica
    https://www.britannica.com/science/cardiovascular-disease/Diseases-of-the-arteries
    Atherosclerosis, the most common form of arteriosclerosis, is a disease found in large and medium-sized arteries. It is characterized by the deposition of fatty substances, such as cholesterol, in the innermost layer of the artery (the intima). […] The six principal risk factors for atherosclerosis include age, genetics, gender, serum cholesterol concentrations, smoking, and diabetes. The prevalence of atherosclerosis increases with age, and young children with evidence of fatty streaks are very likely to develop the disease when they are older. […] Men develop atherosclerosis more often than women, and complications generally appear at an earlier age. […] Epidemiological observation has demonstrated that patients with high serum cholesterol and lipoprotein concentrations have a higher incidence of atherosclerosis.
  • #27 Cardiovascular disease – Arterial Damage, Risk Factors, Prevention | Britannica
    https://www.britannica.com/science/cardiovascular-disease/Diseases-of-the-arteries
    Atherosclerosis, the most common form of arteriosclerosis, is a disease found in large and medium-sized arteries. It is characterized by the deposition of fatty substances, such as cholesterol, in the innermost layer of the artery (the intima). […] The six principal risk factors for atherosclerosis include age, genetics, gender, serum cholesterol concentrations, smoking, and diabetes. The prevalence of atherosclerosis increases with age, and young children with evidence of fatty streaks are very likely to develop the disease when they are older. […] Men develop atherosclerosis more often than women, and complications generally appear at an earlier age. […] Epidemiological observation has demonstrated that patients with high serum cholesterol and lipoprotein concentrations have a higher incidence of atherosclerosis.
  • #28 Coronary Artery Atherosclerosis: Practice Essentials, Background, Anatomy
    https://emedicine.medscape.com/article/153647-overview
    The incidence, prevalence, and manifestations of CAD vary significantly with race, as does the response to therapy. […] African Americans appear to have higher morbidity and mortality rates of CAD, even when the statistics are corrected for educational and socioeconomic status. The risk-factor burden experienced by African Americans differs from that of Caucasian Americans. The prevalence of hypertension, obesity, dysmetabolic syndrome, and lack of physical activity are much higher in African Americans, whereas the prevalence of hypercholesterolemia is lower. […] The presence of risk factors accelerates the rate of development of atherosclerosis. Diabetes causes endothelial dysfunction, decreases endothelial thromboresistance, and increases platelet activity, thus accelerating atherosclerosis. […] Established risk factors successfully predict future cardiac events in about 50-60% of patients. A concerted effort to identify is also being made to validate new markers of future risk of the clinical consequences of atherosclerosis has been made.
  • #29 Arteriosclerosis / atherosclerosis – Symptoms and causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/arteriosclerosis-atherosclerosis/symptoms-causes/syc-20350569
    Risk factors for atherosclerosis that you can’t control include: Aging. A family history of early heart disease or stroke. Changes in genes that make atherosclerosis more likely. Having inflammatory conditions such as lupus, inflammatory bowel disease or psoriasis. […] The complications of atherosclerosis depend on which arteries are narrowed or blocked. For example: Coronary artery disease. Atherosclerosis in the arteries close to the heart can lead to coronary artery disease. This may cause chest pain, a heart attack or heart failure. […] The same healthy lifestyle changes recommended to treat atherosclerosis also help prevent it. These lifestyle changes can help keep the arteries healthy.
  • #30 Coronary Artery Atherosclerosis: Practice Essentials, Background, Anatomy
    https://emedicine.medscape.com/article/153647-overview
    The incidence, prevalence, and manifestations of CAD vary significantly with race, as does the response to therapy. […] African Americans appear to have higher morbidity and mortality rates of CAD, even when the statistics are corrected for educational and socioeconomic status. The risk-factor burden experienced by African Americans differs from that of Caucasian Americans. The prevalence of hypertension, obesity, dysmetabolic syndrome, and lack of physical activity are much higher in African Americans, whereas the prevalence of hypercholesterolemia is lower. […] The presence of risk factors accelerates the rate of development of atherosclerosis. Diabetes causes endothelial dysfunction, decreases endothelial thromboresistance, and increases platelet activity, thus accelerating atherosclerosis. […] Established risk factors successfully predict future cardiac events in about 50-60% of patients. A concerted effort to identify is also being made to validate new markers of future risk of the clinical consequences of atherosclerosis has been made.
  • #31 Atherosclerosis: Epidemiology and Pathophysiology | Thoracic Key
    https://thoracickey.com/atherosclerosis-epidemiology-and-pathophysiology/
    Large, prospective, community-based observational studies confirmed suspected links between suggested factors and cardiovascular risk. […] The major risk factors and predisposing conditions include dyslipidemia, tobacco use, diabetes mellitus, hypertension, and genetic factors (family history). […] As the prevalence of diabetes among CHD patients increases and other risk factors such as smoking and hypercholesterolemia are better controlled, diabetes is likely to become the predominant risk factor for atherosclerosis. […] Systemic hypertension is well established as a major risk factor for cardiovascular mortality and morbidity in the general population, being more common than cigarette smoking dyslipidemia, and diabetes. […] The INTERHEART study showed that hypertension accounted for 18% risk of a first myocardial infarction. […] It is now clear that systemic and local inflammatory events mediate plaque formation, progression, and degeneration: Atherosclerosis is a chronic inflammatory disease.
  • #32 Atherosclerosis | Nature Reviews Disease Primers
    https://www.nature.com/articles/s41572-019-0106-z
    Atherosclerosis, the formation of fibrofatty lesions in the artery wall, causes much morbidity and mortality worldwide, including most myocardial infarctions and many strokes, as well as disabling peripheral artery disease. […] Development of atherosclerotic lesions probably requires low-density lipoprotein, a particle that carries cholesterol through the blood. […] Other risk factors for atherosclerosis and its thrombotic complications include hypertension, cigarette smoking and diabetes mellitus. […] Increasing evidence also points to a role of the immune system, as emerging risk factors include inflammation and clonal haematopoiesis. […] An array of diagnostic techniques, both invasive (such as selective coronary arteriography) and noninvasive (such as blood biomarkers, stress testing, CT and nuclear scanning), permit assessment of cardiovascular disease risk and targeting of therapies. […] Rapidly accelerating knowledge and continued research promise to provide further progress in combating this common chronic disease.
  • #33 Atherosclerosis from Newborn to Adult-Epidemiology, Pathological Aspects, and Risk Factors – PubMed
    https://pubmed.ncbi.nlm.nih.gov/37895437/
    Cardiovascular disease is the leading cause of mortality and morbidity throughout the world, accounting for 16.7 million deaths each year. The underlying pathological process for the majority of cardiovascular diseases is atherosclerosis, a slowly progressing, multifocal, chronic, immune-inflammatory disease that involves the intima of large and medium-sized arteries. […] The prevalence of atherosclerosis is increasing worldwide and more than 50% of people with circulatory disease die of it, mostly in modern societies. Epidemiological studies have revealed several environmental and genetic risk factors that are associated with the early formation of a pathogenic foundation for atherosclerosis, such as dyslipidemia, hypertension, diabetes mellitus, obesity, and smoking. […] The purpose of this review is to bring together the current information concerning the origin and progression of atherosclerosis in childhood as well as the identification of known risk factors for atherosclerotic cardiovascular disease in children.
  • #34 Atherosclerosis | Nature Reviews Disease Primers
    https://www.nature.com/articles/s41572-019-0106-z
    Atherosclerosis, the formation of fibrofatty lesions in the artery wall, causes much morbidity and mortality worldwide, including most myocardial infarctions and many strokes, as well as disabling peripheral artery disease. […] Development of atherosclerotic lesions probably requires low-density lipoprotein, a particle that carries cholesterol through the blood. […] Other risk factors for atherosclerosis and its thrombotic complications include hypertension, cigarette smoking and diabetes mellitus. […] Increasing evidence also points to a role of the immune system, as emerging risk factors include inflammation and clonal haematopoiesis. […] An array of diagnostic techniques, both invasive (such as selective coronary arteriography) and noninvasive (such as blood biomarkers, stress testing, CT and nuclear scanning), permit assessment of cardiovascular disease risk and targeting of therapies. […] Rapidly accelerating knowledge and continued research promise to provide further progress in combating this common chronic disease.
  • #35 Cardiovascular disease – Arterial Damage, Risk Factors, Prevention | Britannica
    https://www.britannica.com/science/cardiovascular-disease/Diseases-of-the-arteries
    Atherosclerosis, the most common form of arteriosclerosis, is a disease found in large and medium-sized arteries. It is characterized by the deposition of fatty substances, such as cholesterol, in the innermost layer of the artery (the intima). […] The six principal risk factors for atherosclerosis include age, genetics, gender, serum cholesterol concentrations, smoking, and diabetes. The prevalence of atherosclerosis increases with age, and young children with evidence of fatty streaks are very likely to develop the disease when they are older. […] Men develop atherosclerosis more often than women, and complications generally appear at an earlier age. […] Epidemiological observation has demonstrated that patients with high serum cholesterol and lipoprotein concentrations have a higher incidence of atherosclerosis.
  • #36 Atherosclerosis: Epidemiology and Pathophysiology | Thoracic Key
    https://thoracickey.com/atherosclerosis-epidemiology-and-pathophysiology/
    Large, prospective, community-based observational studies confirmed suspected links between suggested factors and cardiovascular risk. […] The major risk factors and predisposing conditions include dyslipidemia, tobacco use, diabetes mellitus, hypertension, and genetic factors (family history). […] As the prevalence of diabetes among CHD patients increases and other risk factors such as smoking and hypercholesterolemia are better controlled, diabetes is likely to become the predominant risk factor for atherosclerosis. […] Systemic hypertension is well established as a major risk factor for cardiovascular mortality and morbidity in the general population, being more common than cigarette smoking dyslipidemia, and diabetes. […] The INTERHEART study showed that hypertension accounted for 18% risk of a first myocardial infarction. […] It is now clear that systemic and local inflammatory events mediate plaque formation, progression, and degeneration: Atherosclerosis is a chronic inflammatory disease.
  • #37 Coronary Artery Atherosclerosis: Practice Essentials, Background, Anatomy
    https://emedicine.medscape.com/article/153647-overview
    The incidence, prevalence, and manifestations of CAD vary significantly with race, as does the response to therapy. […] African Americans appear to have higher morbidity and mortality rates of CAD, even when the statistics are corrected for educational and socioeconomic status. The risk-factor burden experienced by African Americans differs from that of Caucasian Americans. The prevalence of hypertension, obesity, dysmetabolic syndrome, and lack of physical activity are much higher in African Americans, whereas the prevalence of hypercholesterolemia is lower. […] The presence of risk factors accelerates the rate of development of atherosclerosis. Diabetes causes endothelial dysfunction, decreases endothelial thromboresistance, and increases platelet activity, thus accelerating atherosclerosis. […] Established risk factors successfully predict future cardiac events in about 50-60% of patients. A concerted effort to identify is also being made to validate new markers of future risk of the clinical consequences of atherosclerosis has been made.
  • #38 Cardiovascular disease – Arterial Damage, Risk Factors, Prevention | Britannica
    https://www.britannica.com/science/cardiovascular-disease/Diseases-of-the-arteries
    Smoking may increase the risk of developing atherosclerosis and its associated complications, with one pack of cigarettes a day doubling the risk and two packs a day tripling it. […] Incidence of atherosclerotic disease and its complications in patients with either type 1 (insulin-dependent) or type 2 (non-insulin-dependent) diabetes is significantly higher than in healthy individuals. […] In addition to these primary risk factors, there is substantial evidence that other factors, such as sedentary lifestyle, environmental stress, and obesity, increase risk.
  • #39 Atherosclerosis: Epidemiology and Pathophysiology | Thoracic Key
    https://thoracickey.com/atherosclerosis-epidemiology-and-pathophysiology/
    Large, prospective, community-based observational studies confirmed suspected links between suggested factors and cardiovascular risk. […] The major risk factors and predisposing conditions include dyslipidemia, tobacco use, diabetes mellitus, hypertension, and genetic factors (family history). […] As the prevalence of diabetes among CHD patients increases and other risk factors such as smoking and hypercholesterolemia are better controlled, diabetes is likely to become the predominant risk factor for atherosclerosis. […] Systemic hypertension is well established as a major risk factor for cardiovascular mortality and morbidity in the general population, being more common than cigarette smoking dyslipidemia, and diabetes. […] The INTERHEART study showed that hypertension accounted for 18% risk of a first myocardial infarction. […] It is now clear that systemic and local inflammatory events mediate plaque formation, progression, and degeneration: Atherosclerosis is a chronic inflammatory disease.
  • #40 Cardiovascular disease – Arterial Damage, Risk Factors, Prevention | Britannica
    https://www.britannica.com/science/cardiovascular-disease/Diseases-of-the-arteries
    Smoking may increase the risk of developing atherosclerosis and its associated complications, with one pack of cigarettes a day doubling the risk and two packs a day tripling it. […] Incidence of atherosclerotic disease and its complications in patients with either type 1 (insulin-dependent) or type 2 (non-insulin-dependent) diabetes is significantly higher than in healthy individuals. […] In addition to these primary risk factors, there is substantial evidence that other factors, such as sedentary lifestyle, environmental stress, and obesity, increase risk.
  • #41 Cardiovascular disease – Arterial Damage, Risk Factors, Prevention | Britannica
    https://www.britannica.com/science/cardiovascular-disease/Diseases-of-the-arteries
    Smoking may increase the risk of developing atherosclerosis and its associated complications, with one pack of cigarettes a day doubling the risk and two packs a day tripling it. […] Incidence of atherosclerotic disease and its complications in patients with either type 1 (insulin-dependent) or type 2 (non-insulin-dependent) diabetes is significantly higher than in healthy individuals. […] In addition to these primary risk factors, there is substantial evidence that other factors, such as sedentary lifestyle, environmental stress, and obesity, increase risk.
  • #42 Atherosclerosis from Newborn to Adult-Epidemiology, Pathological Aspects, and Risk Factors – PubMed
    https://pubmed.ncbi.nlm.nih.gov/37895437/
    Cardiovascular disease is the leading cause of mortality and morbidity throughout the world, accounting for 16.7 million deaths each year. The underlying pathological process for the majority of cardiovascular diseases is atherosclerosis, a slowly progressing, multifocal, chronic, immune-inflammatory disease that involves the intima of large and medium-sized arteries. […] The prevalence of atherosclerosis is increasing worldwide and more than 50% of people with circulatory disease die of it, mostly in modern societies. Epidemiological studies have revealed several environmental and genetic risk factors that are associated with the early formation of a pathogenic foundation for atherosclerosis, such as dyslipidemia, hypertension, diabetes mellitus, obesity, and smoking. […] The purpose of this review is to bring together the current information concerning the origin and progression of atherosclerosis in childhood as well as the identification of known risk factors for atherosclerotic cardiovascular disease in children.
  • #43 Cardiovascular disease – Arterial Damage, Risk Factors, Prevention | Britannica
    https://www.britannica.com/science/cardiovascular-disease/Diseases-of-the-arteries
    Smoking may increase the risk of developing atherosclerosis and its associated complications, with one pack of cigarettes a day doubling the risk and two packs a day tripling it. […] Incidence of atherosclerotic disease and its complications in patients with either type 1 (insulin-dependent) or type 2 (non-insulin-dependent) diabetes is significantly higher than in healthy individuals. […] In addition to these primary risk factors, there is substantial evidence that other factors, such as sedentary lifestyle, environmental stress, and obesity, increase risk.
  • #44
    http://benthamscience.com/public/chapter/21850
    Atherosclerosis is characterized by hardening/narrowing of arteries and reduction of blood flow to vital organs. […] Early diagnosis of atherosclerosis reduces mortality, morbidity, and healthcare expenditures. […] Overwhelming evidence suggests that regular physical activity (30 min/day), cessation of cigarette smoking, and consumption of antioxidant nutraceuticals rich in flavonoids and retinoids, fresh vegetables and fruits, omega-3 PUFA, culinary spices, probiotics, Mediterranean-type diet, and DASH DIET lower the risk of atherogenesis and cardiovascular diseases. […] New preventative measures and alternative therapies, including dietary interventions and plant-based foods may be the most cost-effective ways to manage atherosclerosis and cardiovascular illnesses.
  • #45 Atherosclerosis | Nature Reviews Disease Primers
    https://www.nature.com/articles/s41572-019-0106-z
    Atherosclerosis, the formation of fibrofatty lesions in the artery wall, causes much morbidity and mortality worldwide, including most myocardial infarctions and many strokes, as well as disabling peripheral artery disease. […] Development of atherosclerotic lesions probably requires low-density lipoprotein, a particle that carries cholesterol through the blood. […] Other risk factors for atherosclerosis and its thrombotic complications include hypertension, cigarette smoking and diabetes mellitus. […] Increasing evidence also points to a role of the immune system, as emerging risk factors include inflammation and clonal haematopoiesis. […] An array of diagnostic techniques, both invasive (such as selective coronary arteriography) and noninvasive (such as blood biomarkers, stress testing, CT and nuclear scanning), permit assessment of cardiovascular disease risk and targeting of therapies. […] Rapidly accelerating knowledge and continued research promise to provide further progress in combating this common chronic disease.
  • #46 Atherosclerosis: Epidemiology and Pathophysiology | Thoracic Key
    https://thoracickey.com/atherosclerosis-epidemiology-and-pathophysiology/
    Large, prospective, community-based observational studies confirmed suspected links between suggested factors and cardiovascular risk. […] The major risk factors and predisposing conditions include dyslipidemia, tobacco use, diabetes mellitus, hypertension, and genetic factors (family history). […] As the prevalence of diabetes among CHD patients increases and other risk factors such as smoking and hypercholesterolemia are better controlled, diabetes is likely to become the predominant risk factor for atherosclerosis. […] Systemic hypertension is well established as a major risk factor for cardiovascular mortality and morbidity in the general population, being more common than cigarette smoking dyslipidemia, and diabetes. […] The INTERHEART study showed that hypertension accounted for 18% risk of a first myocardial infarction. […] It is now clear that systemic and local inflammatory events mediate plaque formation, progression, and degeneration: Atherosclerosis is a chronic inflammatory disease.
  • #47 Coronary Artery Atherosclerosis: Practice Essentials, Background, Anatomy
    https://emedicine.medscape.com/article/153647-overview
    The incidence, prevalence, and manifestations of CAD vary significantly with race, as does the response to therapy. […] African Americans appear to have higher morbidity and mortality rates of CAD, even when the statistics are corrected for educational and socioeconomic status. The risk-factor burden experienced by African Americans differs from that of Caucasian Americans. The prevalence of hypertension, obesity, dysmetabolic syndrome, and lack of physical activity are much higher in African Americans, whereas the prevalence of hypercholesterolemia is lower. […] The presence of risk factors accelerates the rate of development of atherosclerosis. Diabetes causes endothelial dysfunction, decreases endothelial thromboresistance, and increases platelet activity, thus accelerating atherosclerosis. […] Established risk factors successfully predict future cardiac events in about 50-60% of patients. A concerted effort to identify is also being made to validate new markers of future risk of the clinical consequences of atherosclerosis has been made.
  • #48 Association between neutrophil count and the risk of cardiovascular disease: A community-based cohort study in Taiwan | PLOS One
    https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0322645
    Neutrophil count is associated with atherosclerotic plaque formation and cardiovascular diseases (CVD). As previous studies have been predominantly conducted in Caucasians, the significance of neutrophil count as a clinical factor in CVD in other ethnicities remain unclear. […] Over a median follow-up period of 22 years, 400 cases of new-onset CVD were recorded. Cox proportional hazards regression analysis revealed that a higher neutrophil count was independently associated with CVD incidence in Taiwanese adults, with an HR of 1.42 (95% CI 1.03-1.94) after adjusting for multiple covariates. This association remained consistent in both the subgroup and sensitivity analyses. […] Our study demonstrated that, in the Taiwanese population, a higher neutrophil count was associated with a higher incidence of CVD over an average 22-year follow-up in individuals without preexisting CVD.
  • #49 RETRACTED ARTICLE: A histopathological analysis of the epidemiology of coronary atherosclerosis: an autopsy study | springermedizin.de
    https://www.springermedizin.de/a-histopathological-analysis-of-the-epidemiology-of-coronary-ath/9771890
    Atherosclerosis accounts for a large proportion of cardiovascular system associated morbidity and mortality. […] The objective of the study was to determine the possible association between the histopathological changes of the coronary atherosclerotic lesions and the risk of sudden cardiac death (SCD) and acute myocardial infarction (AMI) using autopsy cases. […] Atherosclerosis is a pathologically diverse disease with heterogeneous mechanisms of progression. […] In this study, age estimate to be a risk factor for coronary atherosclerosis in individuals more than 50 years old and may be used to predict SCD. […] The study has revealed that ruptured plaques of human autopsied affected were characterized by the presence of a more severe inflammatory infiltrate, constituted by monocytes, macrophages, and lymphocyte cells.
  • #50 RETRACTED ARTICLE: A histopathological analysis of the epidemiology of coronary atherosclerosis: an autopsy study | Diagnostic Pathology | Full Text
    https://diagnosticpathology.biomedcentral.com/articles/10.1186/s13000-015-0324-y
    The autopsy study provides a means of understanding the basic process which sets a stage for clinically significant atherosclerotic cardiovascular disease. […] In this study, the histological examination of the serially sectioned coronary arteries from 13 men and women who died suddenly and unexpectedly revealed the frequent presence of early atherosclerotic lesions in 13 cases. […] Age is a powerful risk factor for coronary heart disease. […] The findings of a study by van der Wal et al. also suggested a predominance of lymphocytes in venous compared with arterial plaques. […] In the present study, it was observed that nine cases (69.34 %) were males and 4 (30.66 %) were females, which are concordant with other researchers findings that showed 74.8 % males and 24.2 % females. […] Coronary artery calcium (CAC) has been demonstrated to be associated with the risk of coronary heart disease. […] Atherosclerosis and coronary artery disease are huge health concerns in Iran.
  • #51 Atherosclerosis Risk in Communities (ARIC) Study | George W. Comstock Center for Public Health Research and Prevention
    https://publichealth.jhu.edu/george-w-comstock-center-for-public-health-research-and-prevention/research-activities/atherosclerosis-risk-in-communities-aric-study
    The Atherosclerosis Risk in Communities (ARIC) study is a prospective epidemiologic study conducted in four U.S. communities, including Washington County, Maryland. […] ARIC includes two components: cohort and community surveillance. […] The community surveillance component is designed to measure the community-wide occurrence of hospitalized myocardial infarction, coronary heart disease deaths in men and women aged 35 to 84 years, and since 2005 heart failure (among those aged 55 years and older).
  • #52 Atherosclerosis Risk in Communities Study
    https://datacatalog.med.nyu.edu/dataset/10043
    The Atherosclerosis Risk in Communities (ARIC) Study is a prospective longitudinal epidemiological study conducted in four communities: Forsyth County (North Carolina), Jackson (Mississippi), Minneapolis (Minnesota), and Washington County (Maryland). ARIC is designed to investigate the causes of atherosclerosis and its clinical outcomes, and variations in cardiovascular risk factors, medical care, and disease by race, gender, location, and date. ARIC consists of two parts: a Cohort Component and a Community Surveillance Component. […] The Community Surveillance Component encompasses approximately 470,000 men and women aged 35 to 84 years old. Data was collected on deaths from cardiovascular heart disease (CHD) and heart failure (HF) among participants aged 35 to 74 years old who were enrolled between 1987-2014, and among participants aged 35 to 84 years old between 2005-2014. From 2005 to 2014, the study also collected information on inpatient heart failure among adults aged 55 years and older and outpatient heart failure in adults aged 65 years and older.
  • #53 Atherosclerosis Risk in Communities Study
    https://datacatalog.med.nyu.edu/dataset/10043
    The Atherosclerosis Risk in Communities (ARIC) Study is a prospective longitudinal epidemiological study conducted in four communities: Forsyth County (North Carolina), Jackson (Mississippi), Minneapolis (Minnesota), and Washington County (Maryland). ARIC is designed to investigate the causes of atherosclerosis and its clinical outcomes, and variations in cardiovascular risk factors, medical care, and disease by race, gender, location, and date. ARIC consists of two parts: a Cohort Component and a Community Surveillance Component. […] The Community Surveillance Component encompasses approximately 470,000 men and women aged 35 to 84 years old. Data was collected on deaths from cardiovascular heart disease (CHD) and heart failure (HF) among participants aged 35 to 74 years old who were enrolled between 1987-2014, and among participants aged 35 to 84 years old between 2005-2014. From 2005 to 2014, the study also collected information on inpatient heart failure among adults aged 55 years and older and outpatient heart failure in adults aged 65 years and older.
  • #54
    https://journals.lww.com/epidem/fulltext/2008/11001/the_multi_ethnic_study_of_atherosclerosis_and_air.78.aspx
    The MESA Air study is a major new multi-center prospective U.S. cohort study, with detailed individual-level air pollution exposure estimation, health and covariate assessment in a multi-ethnic cohort, launched in 2004. […] The EPA-funded MESA Air project will allow a prospective assessment of whether air pollution accelerates atherosclerosis and the occurrence of clinical cardiovascular disease. […] MESA Air has several advantages that should provide important new information on the relation between long-term exposure to air pollution and cardiovascular diseases.
  • #55 Atherosclerosis, Diabetes Mellitus, and Cancer: Common Epidemiology, Shared Mechanisms, and Future Management
    https://www.mdpi.com/1422-0067/24/14/11786
    Atherosclerosis eventually leads to cardiovascular disease (ASCVD), a leading cause of global morbidity and mortality because of potentially hazardous complications, i.e., acute myocardial infarction (MI), stroke, and ischemic cardiomyopathy. Estimated ASCVD-attributed deaths are near the top, accounting for one-third of all deaths. Silent coronary atherosclerosis without an established disease is common in the general population, as shown in a large, random sample of a middle-aged population from Sweden without previous myocardial infarction or coronary intervention, where coronary computed tomography angiography (CCTA) showed that 42.1% of the population had plaques in their coronary arteries. Significant stenosis (≥50%) was less common (in 5.2%), and more severe forms of coronary atherosclerosis, like three-vessel disease, were rarely found (in only 1.9%). The prevalence of CCTA-detected coronary atherosclerosis in this study closely reflects the incidence of ASCVD in many other Western countries.
  • #56 Prevalence of atherosclerosis in individuals with prediabetes and diabetes compared to normoglycaemic individuals—a Swedish population-based study | Cardiovascular Diabetology | Full Text
    https://cardiab.biomedcentral.com/articles/10.1186/s12933-023-01982-6
    Patients with type 2 diabetes have an increased risk of death and cardiovascular events and people with diabetes or prediabetes have been found to have increased atherosclerotic burden in the coronary and carotid arteries. […] This study will estimate the cross-sectional prevalence of atherosclerosis in the coronary and carotid arteries in individuals with prediabetes and diabetes, compared with normoglycaemic individuals in a large population-based cohort. […] Study participants with prediabetes (n=4804, 16.0%) or diabetes (n=2282, 7.6%) had greater coronary artery plaque burden, more coronary stenosis and higher CACS than normoglycaemic participants (all, p0.01). […] The prevalence of atherosclerosis in the coronary arteries was higher in participants with previously undetected diabetes than prediabetes, but lower than in patients with known diabetes.
  • #57 RETRACTED ARTICLE: A histopathological analysis of the epidemiology of coronary atherosclerosis: an autopsy study | Diagnostic Pathology | Full Text
    https://diagnosticpathology.biomedcentral.com/articles/10.1186/s13000-015-0324-y
    Atherosclerosis accounts for a large proportion of cardiovascular system associated morbidity and mortality. […] The objective of the study was to determine the possible association between the histopathological changes of the coronary atherosclerotic lesions and the risk of sudden cardiac death (SCD) and acute myocardial infarction (AMI) using autopsy cases. […] Atherosclerotic plaques were identified in 6.5 % of specimens, 69.34 % of males and 30.66 % of female. […] In this study, age estimate to be a risk factor for coronary atherosclerosis in individuals more than 50 years old and may be used to predict SCD. […] Atherosclerosis is a disease of large- and medium-sized muscular arteries, characterized by inflammation of smooth muscle cells and formation of atherosclerotic plaques composed of necrotic cores; calcium deposits; and an accumulation of modified lipids, endothelial cells, leukocytes, and foam cells.
  • #58 RETRACTED ARTICLE: A histopathological analysis of the epidemiology of coronary atherosclerosis: an autopsy study | Diagnostic Pathology | Full Text
    https://diagnosticpathology.biomedcentral.com/articles/10.1186/s13000-015-0324-y
    The autopsy study provides a means of understanding the basic process which sets a stage for clinically significant atherosclerotic cardiovascular disease. […] In this study, the histological examination of the serially sectioned coronary arteries from 13 men and women who died suddenly and unexpectedly revealed the frequent presence of early atherosclerotic lesions in 13 cases. […] Age is a powerful risk factor for coronary heart disease. […] The findings of a study by van der Wal et al. also suggested a predominance of lymphocytes in venous compared with arterial plaques. […] In the present study, it was observed that nine cases (69.34 %) were males and 4 (30.66 %) were females, which are concordant with other researchers findings that showed 74.8 % males and 24.2 % females. […] Coronary artery calcium (CAC) has been demonstrated to be associated with the risk of coronary heart disease. […] Atherosclerosis and coronary artery disease are huge health concerns in Iran.
  • #59 Epidemiology and pathophysiologic insights of coronary atherosclerosis relevant for contemporary non-invasive imaging – Casolo – Cardiovascular Diagnosis and Therapy
    https://cdt.amegroups.org/article/view/51546/html
    In the past few decades cardiovascular (CV) mortality, myocardial infarction (MI) and stroke incidence, severity of coronary atherosclerosis have greatly decreased thus changing the prognostic and diagnostic landscape of patients with suspected or confirmed CAD. […] The observed decrease in CV events in the general population has been recorded almost universally and applies to all the most common complications of atherosclerotic vessels disease. […] The burden of coronary atherosclerosis also seems to ease. […] The recent European Society of Cardiology (ESC) guidelines have coined the term of chronic coronary syndromes (CCS) in the attempt to embrace several different conditions other than ACS. […] The contemporary accuracy of these old tests appear much lower than in the past. […] The earlier the better. At the same time, a growing number of data from clinical studies have shown a significant prognostic role for non-obstructive CAD and coronary atherosclerosis.
  • #60 Epidemiology and pathophysiologic insights of coronary atherosclerosis relevant for contemporary non-invasive imaging – Casolo – Cardiovascular Diagnosis and Therapy
    https://cdt.amegroups.org/article/view/51546/html
    In the past few decades cardiovascular (CV) mortality, myocardial infarction (MI) and stroke incidence, severity of coronary atherosclerosis have greatly decreased thus changing the prognostic and diagnostic landscape of patients with suspected or confirmed CAD. […] The observed decrease in CV events in the general population has been recorded almost universally and applies to all the most common complications of atherosclerotic vessels disease. […] The burden of coronary atherosclerosis also seems to ease. […] The recent European Society of Cardiology (ESC) guidelines have coined the term of chronic coronary syndromes (CCS) in the attempt to embrace several different conditions other than ACS. […] The contemporary accuracy of these old tests appear much lower than in the past. […] The earlier the better. At the same time, a growing number of data from clinical studies have shown a significant prognostic role for non-obstructive CAD and coronary atherosclerosis.
  • #61 Coronary Artery Atherosclerosis: Practice Essentials, Background, Anatomy
    https://emedicine.medscape.com/article/153647-overview
    Annually, approximately 1.5 million Americans have an AMI, a third of whom die. In 2009, 785,000 Americans were estimated to have suffered a first MI, and about 470,000 Americans were estimated to have had a recurrent event. An additional 195,000 „silent” heart attacks are estimated to occur each year. About every 34 seconds, an American will have an MI. CAD remains the number 1 cause of death for men and women in the United States and is responsible for approximately 20% of all US deaths. From 1995-2005, the death rate from CAD declined 34.3%, but the actual number of deaths declined only 19.4%. […] The international incidence of ACS and AMI, especially in developed countries, is similar to that observed in the United States. Despite consumption of rich foods, inhabitants of France and the Mediterranean region appear to have a lower incidence of CAD. This phenomenon (sometimes called the French paradox) is partly explained by greater use of alcohol, with its possible HDL-raising benefit, and by consumption of the Mediterranean diet, which includes predominant use of monounsaturated fatty acids, such as olive oil or canola oil, as well as omega-3 fatty acids, which are less atherogenic.
  • #62 Rapid emergence of atherosclerosis in Asia: a systematic review of coronary atherosclerotic heart disease epidemiology and implications for prevention and control strategies
    https://eprints.gla.ac.uk/110910/
    There is a global epidemic of coronary heart disease (CHD) caused by atherosclerosis. […] Most countries in Asia are experiencing the challenges from CHD, with the mortality rate varying from 103 to 366 per 100 000 adult populations, reported by recently published studies. […] During the past decade, there was a marked rising trend of atherosclerosis-related burden particularly in Eastern Asia where an alarming increase of 117.2 and 115.3% of total deaths and disability adjusted life-years, respectively, were observed. […] The rise of CHD could be attributed to unhealthy lifestyles, clinical-risk factors, psychosocial factors, and public health transitions. […] Ageing, urbanization, and increase in prosperity may serve as underlying key drivers. […] The burden of CHD is substantial, whereas contributors are multifactorial. […] The formulation of public health measures will need to adopt an integrated and life-course approach, based on the need and risks of different population subgroups in Asia.
  • #63 Atherosclerosis Pathology: Definition, Etiology, Epidemiology
    https://emedicine.medscape.com/article/1612610-overview
    Despite advances in medical, interventional, and surgical treatment, atherosclerotic disease remains the most important cause of death in developed and underprivileged nations. […] In the United States, coronary heart disease accounted for 375,476 deaths in 2021. Each year, a substantial number of Americans experience a myocardial infarction (MI), with 605,000 being first-time events and 200,000 recurrent episodes. […] Coronary artery disease remains the leading cause of death in the Western world. A new or recurrent MI afflicts approximately 1.1 million people in the USA per year, of which 40% are fatal. […] Sudden cardiac death as a first manifestation of the atherosclerotic process occurs in over 450,000 individuals annually. The vast majority of acute MIs (approximately 75%) occur from plaque rupture; other causes of coronary thrombosis include erosion and calcified nodules.
  • #64 Epidemiology and Clinical Researches in Atherosclerosis and Cardiovascular Disease | Frontiers Research Topic
    https://www.frontiersin.org/research-topics/40371/epidemiology-and-clinical-researches-in-atherosclerosis-and-cardiovascular-disease/magazine
    Atherosclerosis is a systemic disease and the common cause of heart attacks, strokes and peripheral vascular disease collectively referred to as cardiovascular diseases (CVD), which are the leading cause of global mortality and a major contributor to disability and rising health care costs. The global number of total CVD nearly doubled from 271 million in 1990 to 523 million in 2019, and the number of CVD deaths steadily increased from 12.1 million in 1990, reaching 18.6 million in 2019. By 2030, approximately 23.6 million people are predicted to die from CVD annually. The huge and still growing burden of CVD on individuals, families, and health-care systems indicates an urgent need for prevention and treatment measures on atherosclerotic diseases. Preventing severe atherosclerosis progression is expected to decrease high cardiovascular event rate. However, there still exist challenges to be addressed. These challenges include but are not limited to 1) early detect participants with high-risk of CVD; 2) identify novel indicators for progression and prognosis of atherosclerotic diseases; 3) comorbidities of atherosclerotic diseases; 4) new drugs and therapies on atherosclerosis and CVD.
  • #65 Epidemiology and Clinical Researches in Atherosclerosis and Cardiovascular Disease | Frontiers Research Topic
    https://www.frontiersin.org/research-topics/40371/epidemiology-and-clinical-researches-in-atherosclerosis-and-cardiovascular-disease/magazine
    Atherosclerosis is a systemic disease and the common cause of heart attacks, strokes and peripheral vascular disease collectively referred to as cardiovascular diseases (CVD), which are the leading cause of global mortality and a major contributor to disability and rising health care costs. The global number of total CVD nearly doubled from 271 million in 1990 to 523 million in 2019, and the number of CVD deaths steadily increased from 12.1 million in 1990, reaching 18.6 million in 2019. By 2030, approximately 23.6 million people are predicted to die from CVD annually. The huge and still growing burden of CVD on individuals, families, and health-care systems indicates an urgent need for prevention and treatment measures on atherosclerotic diseases. Preventing severe atherosclerosis progression is expected to decrease high cardiovascular event rate. However, there still exist challenges to be addressed. These challenges include but are not limited to 1) early detect participants with high-risk of CVD; 2) identify novel indicators for progression and prognosis of atherosclerotic diseases; 3) comorbidities of atherosclerotic diseases; 4) new drugs and therapies on atherosclerosis and CVD.
  • #66 Rapid emergence of atherosclerosis in Asia: a systematic review of coronary atherosclerotic heart disease epidemiology and implications for prevention and control strategies
    https://eprints.gla.ac.uk/110910/
    There is a global epidemic of coronary heart disease (CHD) caused by atherosclerosis. […] Most countries in Asia are experiencing the challenges from CHD, with the mortality rate varying from 103 to 366 per 100 000 adult populations, reported by recently published studies. […] During the past decade, there was a marked rising trend of atherosclerosis-related burden particularly in Eastern Asia where an alarming increase of 117.2 and 115.3% of total deaths and disability adjusted life-years, respectively, were observed. […] The rise of CHD could be attributed to unhealthy lifestyles, clinical-risk factors, psychosocial factors, and public health transitions. […] Ageing, urbanization, and increase in prosperity may serve as underlying key drivers. […] The burden of CHD is substantial, whereas contributors are multifactorial. […] The formulation of public health measures will need to adopt an integrated and life-course approach, based on the need and risks of different population subgroups in Asia.
  • #67 Atherosclerosis: Epidemiology and Pathophysiology | Thoracic Key
    https://thoracickey.com/atherosclerosis-epidemiology-and-pathophysiology/
    This chapter will focus mainly on the epidemiology, biology, and clinical manifestations of atherosclerosis, with a special emphasis on the emerging dominant role for inflammation in this disease. […] In 2002, the estimated prevalence of total cardiovascular disease (CVD), coronary heart disease (CHD), and congestive heart failure (CHF) in the U.S. population was 70 million, 13 million, and 4.9 million, respectively. […] CVD accounted for 38% of all deaths, or 1 of every 2.6 deaths, in 2002. […] According to current statistics and estimates, 865,000 new and recurrent myocardial infarctions and 700,000 new and recurrent stroke attacks are expected annually. […] Furthermore, the economic impact of atherosclerotic disease is staggering. […] Epidemiological studies (both experimental and observational) over the last 50 years have identified several risk factors for the development of atherosclerosis.
  • #68 Coronary Artery Atherosclerosis: Practice Essentials, Background, Anatomy
    https://emedicine.medscape.com/article/153647-overview
    The true frequency of atherosclerosis is difficult, if not impossible, to accurately determine because it is a predominantly asymptomatic condition. The process of atherosclerosis begins in childhood with the development of fatty streaks. These lesions can be found in the aorta shortly after birth and appear in increasing numbers in those aged 8-18 years. More advanced lesions begin to develop when individuals are aged approximately 25 years. Subsequently, an increasing prevalence of the advanced complicated lesions of atherosclerosis is noted, and the organ-specific clinical manifestations of the disease increase with age through the fifth and sixth decades of life. […] In the United States, approximately 14 million persons experience CAD and its various complications. Congestive heart failure (CHF) that develops because of ischemic cardiomyopathy in hypertensive MI survivors has become the most common discharge diagnosis for patients in American hospitals. Approximately 80 million people, or 36.3% of the population, have cardiovascular disease.
  • #69 RETRACTED ARTICLE: A histopathological analysis of the epidemiology of coronary atherosclerosis: an autopsy study | springermedizin.de
    https://www.springermedizin.de/a-histopathological-analysis-of-the-epidemiology-of-coronary-ath/9771890
    In the present study, calcium in the coronary plaque is often fragmented and may be located deep in the plaque or close to the surface. […] Atherosclerosis and coronary artery disease are huge health concerns in Iran. They constitute the largest single cause of death and exact a financial burden of billions of dollars annually.
  • #70 Epidemiology and Clinical Researches in Atherosclerosis and Cardiovascular Disease | Frontiers Research Topic
    https://www.frontiersin.org/research-topics/40371/epidemiology-and-clinical-researches-in-atherosclerosis-and-cardiovascular-disease/magazine
    Atherosclerosis is a systemic disease and the common cause of heart attacks, strokes and peripheral vascular disease collectively referred to as cardiovascular diseases (CVD), which are the leading cause of global mortality and a major contributor to disability and rising health care costs. The global number of total CVD nearly doubled from 271 million in 1990 to 523 million in 2019, and the number of CVD deaths steadily increased from 12.1 million in 1990, reaching 18.6 million in 2019. By 2030, approximately 23.6 million people are predicted to die from CVD annually. The huge and still growing burden of CVD on individuals, families, and health-care systems indicates an urgent need for prevention and treatment measures on atherosclerotic diseases. Preventing severe atherosclerosis progression is expected to decrease high cardiovascular event rate. However, there still exist challenges to be addressed. These challenges include but are not limited to 1) early detect participants with high-risk of CVD; 2) identify novel indicators for progression and prognosis of atherosclerotic diseases; 3) comorbidities of atherosclerotic diseases; 4) new drugs and therapies on atherosclerosis and CVD.
  • #71
    http://benthamscience.com/public/chapter/21850
    Atherosclerosis is characterized by hardening/narrowing of arteries and reduction of blood flow to vital organs. […] Early diagnosis of atherosclerosis reduces mortality, morbidity, and healthcare expenditures. […] Overwhelming evidence suggests that regular physical activity (30 min/day), cessation of cigarette smoking, and consumption of antioxidant nutraceuticals rich in flavonoids and retinoids, fresh vegetables and fruits, omega-3 PUFA, culinary spices, probiotics, Mediterranean-type diet, and DASH DIET lower the risk of atherogenesis and cardiovascular diseases. […] New preventative measures and alternative therapies, including dietary interventions and plant-based foods may be the most cost-effective ways to manage atherosclerosis and cardiovascular illnesses.
  • #72
    http://benthamscience.com/public/chapter/21850
    Atherosclerosis is characterized by hardening/narrowing of arteries and reduction of blood flow to vital organs. […] Early diagnosis of atherosclerosis reduces mortality, morbidity, and healthcare expenditures. […] Overwhelming evidence suggests that regular physical activity (30 min/day), cessation of cigarette smoking, and consumption of antioxidant nutraceuticals rich in flavonoids and retinoids, fresh vegetables and fruits, omega-3 PUFA, culinary spices, probiotics, Mediterranean-type diet, and DASH DIET lower the risk of atherogenesis and cardiovascular diseases. […] New preventative measures and alternative therapies, including dietary interventions and plant-based foods may be the most cost-effective ways to manage atherosclerosis and cardiovascular illnesses.
  • #73 Epidemiology and Clinical Researches in Atherosclerosis and Cardiovascular Disease | Frontiers Research Topic
    https://www.frontiersin.org/research-topics/40371/epidemiology-and-clinical-researches-in-atherosclerosis-and-cardiovascular-disease/magazine
    Atherosclerosis is a systemic disease and the common cause of heart attacks, strokes and peripheral vascular disease collectively referred to as cardiovascular diseases (CVD), which are the leading cause of global mortality and a major contributor to disability and rising health care costs. The global number of total CVD nearly doubled from 271 million in 1990 to 523 million in 2019, and the number of CVD deaths steadily increased from 12.1 million in 1990, reaching 18.6 million in 2019. By 2030, approximately 23.6 million people are predicted to die from CVD annually. The huge and still growing burden of CVD on individuals, families, and health-care systems indicates an urgent need for prevention and treatment measures on atherosclerotic diseases. Preventing severe atherosclerosis progression is expected to decrease high cardiovascular event rate. However, there still exist challenges to be addressed. These challenges include but are not limited to 1) early detect participants with high-risk of CVD; 2) identify novel indicators for progression and prognosis of atherosclerotic diseases; 3) comorbidities of atherosclerotic diseases; 4) new drugs and therapies on atherosclerosis and CVD.
  • #74 Epidemiology and pathophysiologic insights of coronary atherosclerosis relevant for contemporary non-invasive imaging – Casolo – Cardiovascular Diagnosis and Therapy
    https://cdt.amegroups.org/article/view/51546/html
    The major attention has been directed on detecting coronary atherosclerosis. […] The decreased probability of disease has made difficult to both predict and diagnose CAD. […] The depiction of the presence, extent, severity, and quality of coronary atherosclerosis appear to be the main diagnostic target of contemporary imaging in patients with suspected or confirmed CAD or IHD.
  • #75 Epidemiology and pathophysiologic insights of coronary atherosclerosis relevant for contemporary non-invasive imaging – Casolo – Cardiovascular Diagnosis and Therapy
    https://cdt.amegroups.org/article/view/51546/html
    The major attention has been directed on detecting coronary atherosclerosis. […] The decreased probability of disease has made difficult to both predict and diagnose CAD. […] The depiction of the presence, extent, severity, and quality of coronary atherosclerosis appear to be the main diagnostic target of contemporary imaging in patients with suspected or confirmed CAD or IHD.
  • #76 Atherosclerosis | Nature Reviews Disease Primers
    https://www.nature.com/articles/s41572-019-0106-z
    Atherosclerosis, the formation of fibrofatty lesions in the artery wall, causes much morbidity and mortality worldwide, including most myocardial infarctions and many strokes, as well as disabling peripheral artery disease. […] Development of atherosclerotic lesions probably requires low-density lipoprotein, a particle that carries cholesterol through the blood. […] Other risk factors for atherosclerosis and its thrombotic complications include hypertension, cigarette smoking and diabetes mellitus. […] Increasing evidence also points to a role of the immune system, as emerging risk factors include inflammation and clonal haematopoiesis. […] An array of diagnostic techniques, both invasive (such as selective coronary arteriography) and noninvasive (such as blood biomarkers, stress testing, CT and nuclear scanning), permit assessment of cardiovascular disease risk and targeting of therapies. […] Rapidly accelerating knowledge and continued research promise to provide further progress in combating this common chronic disease.
  • #77 Atherosclerosis | Nature Reviews Disease Primers
    https://www.nature.com/articles/s41572-019-0106-z
    Atherosclerosis, the formation of fibrofatty lesions in the artery wall, causes much morbidity and mortality worldwide, including most myocardial infarctions and many strokes, as well as disabling peripheral artery disease. […] Development of atherosclerotic lesions probably requires low-density lipoprotein, a particle that carries cholesterol through the blood. […] Other risk factors for atherosclerosis and its thrombotic complications include hypertension, cigarette smoking and diabetes mellitus. […] Increasing evidence also points to a role of the immune system, as emerging risk factors include inflammation and clonal haematopoiesis. […] An array of diagnostic techniques, both invasive (such as selective coronary arteriography) and noninvasive (such as blood biomarkers, stress testing, CT and nuclear scanning), permit assessment of cardiovascular disease risk and targeting of therapies. […] Rapidly accelerating knowledge and continued research promise to provide further progress in combating this common chronic disease.
  • #78
    https://journals.lww.com/epidem/fulltext/2009/03000/fine_particulate_matter_air_pollution,_proximity.18.aspx
    The initiation and acceleration of atherosclerosis is hypothesized as a physiologic mechanism underlying associations between air pollution and cardiovascular effects. […] In this cross-sectional analysis we investigated exposure to fine particulate matter (PM2.5) and residential proximity to major roads in relation to abdominal aortic calcification, a sensitive indicator of systemic atherosclerosis. […] Although we did not find persuasive associations across our full study population, associations were stronger among participants with less exposure misclassification. These findings support the hypothesis of a relationship between particulate air pollution and systemic atherosclerosis.
  • #79 Endothelial AGO1 Drives Vascular Inflammation and Atherosclerosis via a Non-Canonical Nuclear Mechanism | bioRxiv
    https://www.biorxiv.org/content/10.1101/2025.05.01.651783v1
    BACKGROUND Endothelial cell (EC) dysfunction is both a cause and consequence of vascular inflammation and lipid dysregulation in atherosclerosis, yet the molecular drivers linking EC dysfunction to systemic metabolic derangements remain incompletely understood. […] CONCLUSIONS Endothelial AGO1 promotes vascular inflammation and liver dysfunction through a non-canonical role as an NF-κB coactivator. Its inhibition provides dual benefits—ameliorating lipid dysregulation and suppressing vascular inflammation—highlighting EC-AGO1 as a promising therapeutic target for atherosclerosis and cardiometabolic diseases.