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[Atherosclerosis as a systemic disease]
1Unidad de Arteriosclerosis, Hospital Carlos III, Madrid, Spain. clahoz.hciii@salud.madrid.org
Insights
Atherosclerosis, a progressive arterial disease, causes significant mortality and morbidity globally. Early detection and systemic treatments like statins are crucial for managing this widespread condition.
Area of Science:
- Cardiovascular Science
- Vascular Biology
- Public Health
Context:
- Atherosclerosis is a prevalent, progressive disease affecting medium-sized arteries, leading to ischemic heart disease, cerebrovascular disease, and peripheral arterial disease.
- In Spain, it causes 124,000 deaths annually, posing a substantial public health challenge despite declining aged-adjusted cardiovascular mortality rates.
Purpose:
- To summarize the nature, risk factors, detection methods, and systemic treatment strategies for atherosclerosis.
- To highlight the importance of recognizing atherosclerosis as a systemic disease affecting multiple vascular beds.
Summary:
- Atherosclerosis involves medium arteries and presents clinically as various ischemic diseases. Risk factors are universal across affected areas.
- Subclinical atherosclerosis can be identified using risk tables, inflammatory markers, imaging, and the ankle-brachial index.
- Systemic treatments including statins, antiplatelet agents, and ACE inhibitors are effective regardless of the affected vascular territory.
Impact:
- Understanding atherosclerosis as a systemic disease informs comprehensive patient management strategies.
- Early identification and intervention can mitigate the significant morbidity and mortality associated with atherosclerosis.
- Consistent therapeutic approaches offer broad benefits across different vascular manifestations of the disease.
Abstract:
Atherosclerosis is a widespread, chronic progressive disease that mainly involves medium-sized arteries. Clinically, it can become apparent as ischemic heart disease, cerebrovascular disease, or peripheral arterial disease. In Spain, atherosclerosis is responsible for 124,000 deaths each year. Despite the trend towards a reduction in the aged-adjusted mortality rate for cardiovascular disease, the public health burden is expected to increase. The risk factors are the same for all affected vascular beds, regardless of location, and can be classified as either causal, conditional or predisposing. The presence of atherosclerosis in a particular vascular bed is frequently associated with disease in other vascular territories. Risk assessment tables, inflammatory markers, imaging, and the ankle-brachial index can help in identifying subclinical atherosclerosis. Given the systemic nature of the disease, treatment with statins, antiplatelet agents and angiotensin-converting enzyme inhibitors have consistently proven beneficial, irrespective of the vascular bed affected.
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