Pathophysiology and Medical Treatment of Carotid Artery Stenosis

Area of Science:

• Cardiovascular Medicine
• Neurology
• Vascular Biology

Background:

• Stroke is a leading cause of mortality, with ischemic strokes often resulting from carotid artery stenosis (CAS).
• Significant CAS affects 7-9% of the population, with higher prevalence in men and those with peripheral arterial disease.
• Atherosclerosis, the underlying cause of CAS, is driven by risk factors including dyslipidemia, hypertension, diabetes, obesity, smoking, and advanced glycation end products (AGEs).

Purpose of the Study:

• To elucidate the mechanisms of atherosclerosis induced by major risk factors.
• To detail the role of AGEs and their receptors in CAS development and progression.
• To review current and potential therapeutic strategies for managing CAS.

Main Methods:

• Review of the basic mechanisms of atherosclerosis and risk factor induction.
• Detailed discussion on the role of advanced glycation end products (AGEs) and their receptors (RAGE, sRAGE) in CAS.
• Analysis of therapeutic interventions including lifestyle modifications and pharmacological agents.

Main Results:

• Major risk factors like dyslipidemia, hypertension, diabetes, and smoking contribute significantly to atherosclerosis and CAS.
• Advanced glycation end products (AGEs) and their receptor interactions play a critical role in CAS pathogenesis.
• Pharmacological treatments (lipid-lowering, antihypertensive, antidiabetic drugs) and lifestyle changes demonstrate potential to suppress, regress, and slow CAS progression.

Conclusions:

• Lifestyle modifications and medical treatments, including lipid-lowering, antihypertensive, and antidiabetic drugs, are crucial for managing CAS.
• Targeting AGEs and modulating soluble AGE receptors (sRAGE) present promising therapeutic avenues for CAS treatment.
• A combined approach of lifestyle changes and medical interventions can effectively slow CAS progression and promote regression.