Atherosclerosis prevention and risk factor modification

Revision as of 15:25, 13 May 2011 by Atifmohammad (talk | contribs)
(diff) ← Older revision | Latest revision (diff) | Newer revision → (diff)
Jump to navigation Jump to search

WikiDoc Resources for Atherosclerosis prevention and risk factor modification

Articles

Most recent articles on Atherosclerosis prevention and risk factor modification

Most cited articles on Atherosclerosis prevention and risk factor modification

Review articles on Atherosclerosis prevention and risk factor modification

Articles on Atherosclerosis prevention and risk factor modification in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Atherosclerosis prevention and risk factor modification

Images of Atherosclerosis prevention and risk factor modification

Photos of Atherosclerosis prevention and risk factor modification

Podcasts & MP3s on Atherosclerosis prevention and risk factor modification

Videos on Atherosclerosis prevention and risk factor modification

Evidence Based Medicine

Cochrane Collaboration on Atherosclerosis prevention and risk factor modification

Bandolier on Atherosclerosis prevention and risk factor modification

TRIP on Atherosclerosis prevention and risk factor modification

Clinical Trials

Ongoing Trials on Atherosclerosis prevention and risk factor modification at Clinical Trials.gov

Trial results on Atherosclerosis prevention and risk factor modification

Clinical Trials on Atherosclerosis prevention and risk factor modification at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Atherosclerosis prevention and risk factor modification

NICE Guidance on Atherosclerosis prevention and risk factor modification

NHS PRODIGY Guidance

FDA on Atherosclerosis prevention and risk factor modification

CDC on Atherosclerosis prevention and risk factor modification

Books

Books on Atherosclerosis prevention and risk factor modification

News

Atherosclerosis prevention and risk factor modification in the news

Be alerted to news on Atherosclerosis prevention and risk factor modification

News trends on Atherosclerosis prevention and risk factor modification

Commentary

Blogs on Atherosclerosis prevention and risk factor modification

Definitions

Definitions of Atherosclerosis prevention and risk factor modification

Patient Resources / Community

Patient resources on Atherosclerosis prevention and risk factor modification

Discussion groups on Atherosclerosis prevention and risk factor modification

Patient Handouts on Atherosclerosis prevention and risk factor modification

Directions to Hospitals Treating Atherosclerosis prevention and risk factor modification

Risk calculators and risk factors for Atherosclerosis prevention and risk factor modification

Healthcare Provider Resources

Symptoms of Atherosclerosis prevention and risk factor modification

Causes & Risk Factors for Atherosclerosis prevention and risk factor modification

Diagnostic studies for Atherosclerosis prevention and risk factor modification

Treatment of Atherosclerosis prevention and risk factor modification

Continuing Medical Education (CME)

CME Programs on Atherosclerosis prevention and risk factor modification

International

Atherosclerosis prevention and risk factor modification en Espanol

Atherosclerosis prevention and risk factor modification en Francais

Business

Atherosclerosis prevention and risk factor modification in the Marketplace

Patents on Atherosclerosis prevention and risk factor modification

Experimental / Informatics

List of terms related to Atherosclerosis prevention and risk factor modification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Please Take Over This Page and Apply to be Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [2] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.


Template:SIB

Template:WikiDoc Sources Template:Mdr


Atherosclerosis

Atherosclerosis (also known as arteriosclerotic vascular disease or ASVD) is a condition in which an artery wall thickens as a result of the accumulation of fatty materials such as cholesterol. It is a syndrome affecting arterial blood vessels, a chronic inflammatory response in the walls of arteries, caused largely by the accumulation of macrophage white blood cells and promoted by low-density lipoproteins (plasma proteins that carry cholesterol and triglycerides) without adequate removal of fats and cholesterol from the macrophages by functional high density lipoproteins (HDL), (see apoA-1 Milano). It is commonly referred to as a hardening or furring of the arteries. It is caused by the formation of multiple plaques within the arteries.

The atheromatous plaque is divided into three distinct components:

   The atheroma ("lump of gruel," from ἀθήρα, athera, gruel in Greek), which is the nodular accumulation of a soft, flaky, yellowish material at the center of large plaques, composed of macrophages nearest the lumen of the artery
   Underlying areas of cholesterol crystals
   Calcification at the outer base of older/more advanced lesions.

The following terms are similar, yet distinct, in both spelling and meaning, and can be easily confused: arteriosclerosis, arteriolosclerosis, and atherosclerosis. Arteriosclerosis is a general term describing any hardening (and loss of elasticity) of medium or large arteries (from the Greek arteria, meaning artery, and sclerosis, meaning hardening); arteriolosclerosis is any hardening (and loss of elasticity) of arterioles (small arteries); atherosclerosis is a hardening of an artery specifically due to an atheromatous plaque. The term atherogenic is used for substances or processes that cause atherosclerosis.

Atherosclerosis is a chronic disease that remains asymptomatic for decades. Atherosclerotic lesions, or atherosclerotic plaques are separated into two broad categories: Stable and unstable (also called vulnerable). The pathobiology of atherosclerotic lesions is very complicated but generally, stable atherosclerotic plaques, which tend to be asymptomatic, are rich in extracellular matrix and smooth muscle cells, while, unstable plaques are rich in macrophages and foam cells and the extracellular matrix separating the lesion from the arterial lumen (also known as the fibrous cap) is usually weak and prone to rupture. Ruptures of the fibrous cap, expose thrombogenic material, such as collagen to the circulation and eventually induce thrombus formation in the lumen. Upon formation, intraluminal thrombi can occlude arteries outright (i.e. coronary occlusion), but more often they detach, move into the circulation and eventually occlude smaller downstream branches causing thromboembolism (i.e. Stroke is often caused by thrombus formation in the carotid arteries). Apart from thromboembolism, chronically expanding atherosclerotic lesions can cause complete closure of the lumen. Interestingly, chronically expanding lesions are often asymptomatic until lumen stenosis is so severe that blood supply to downstream tissue(s) is insufficient resulting in ischemia.

These complications of advanced atherosclerosis are chronic, slowly progressive and cumulative. Most commonly, soft plaque suddenly ruptures (see vulnerable plaque), causing the formation of a thrombus that will rapidly slow or stop blood flow, leading to death of the tissues fed by the artery in approximately 5 minutes. This catastrophic event is called an infarction. One of the most common recognized scenarios is called coronary thrombosis of a coronary artery, causing myocardial infarction (a heart attack). The same process in an artery to the brain is commonly called stroke. Another common scenario in very advanced disease is claudication from insufficient blood supply to the legs, typically caused by a combination of both stenosis and aneurysmal segments narrowed with clots. Since atherosclerosis is a body-wide process, similar events occur also in the arteries to the brain, intestines, kidneys, legs, etc. Many infarctions involve only very small amounts of tissue and are termed clinically silent, because the person having the infarction does not notice the problem, does not seek medical help or when they do, physicians do not recognize what has happened.