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[Epidemiology of atherosclerosis: risks and paradoxes]
1INSERM U518 Département d'épidémiologie Faculté de médecine Toulouse-Purpan.
Insights
Atherosclerosis presents with diverse clinical issues, including hypercholesterolemia, hypertension, and diabetes, which are key cardiovascular disease risks. Managing these factors, alongside tobacco use, is crucial for preventing events like heart attacks and strokes.
Area of Science:
- Cardiovascular Medicine
- Internal Medicine
- Public Health
Context:
- Atherosclerosis, a condition with varied clinical presentations, poses significant health risks.
- Hypercholesterolemia, hypertension, tobacco use, and diabetes are established risk factors for cardiovascular diseases.
- Current understanding of risk factors explains some population variations but not all.
Purpose:
- To review the clinical manifestations and risk factors associated with atherosclerosis.
- To highlight the impact of hypercholesterolemia, hypertension, tobacco consumption, and diabetes on cardiovascular health.
- To discuss the ongoing assessment of emerging risk factors and their role.
Summary:
- Atherosclerosis manifests clinically in various ways, with hypercholesterolemia being a key risk factor for coronary heart disease, manageable with statins.
- Hypertension is a major stroke risk, while tobacco consumption is linked to lower-limb arterial disease.
- Diabetes globally exacerbates cardiovascular disease; emerging factors like homocysteine are under investigation.
Impact:
- Effective management of hypercholesterolemia with statins reduces ischemic events.
- Understanding and addressing hypertension, tobacco use, and diabetes is critical for stroke and peripheral artery disease prevention.
- Further research into emerging risk factors may refine cardiovascular disease prevention strategies.
Abstract:
Atherosclerosis is characterised by a wide range of clinical manifestations. Hypercholesterolaemia is an independent risk factor for coronary heart disease, the correction of which with statins decreases the incidence of ischaemic events. Hypertension is a major risk for strokes. Prevention of coronary events by an action on the sole arterial blood pressure has been difficult to establish. Tobacco consumption is mainly involved in the risk of lower-limb arterial disease. Diabetes is a major and global enhancer of cardiovascular disease. Assessment of the other "emerging" risk factors (such as vitamin E deficiency, homocysteine, or the type of alcohol consumed) is still in progress. The level of classical risk factors only accounts for the variations between populations that are observed in the United States and in the Northern European countries.