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Regression of atherosclerosis
Abstract:
The reverse of progression of atherosclerotic disease is regression of atherosclerosis: established lesions get smaller. Animal experiments and post mortem findings have provided investigators with considerable evidence of the reversibility of atherosclerosis. It was, however, with arteriography in living man, as used in prospective intervention trials, that proof was given that atherosclerosis can be made to regress. The Leiden Intervention Trial and the Cholesterol Lowering Atherosclerosis Study (CLAS) both have shown that with aggressive lowering of serum cholesterol, be it with diet alone or with diet and cholesterol-lowering drugs, atherosclerosis growth can be retarded and reversed. The Leiden Intervention Trial and the CLAS study stress that cholesterol levels should be lowered in angina pectoris patients and in bypassed patients, whether their cholesterol levels are high or just slightly elevated.
Insights
Atherosclerosis regression, where established lesions shrink, is achievable in living patients. Aggressive cholesterol lowering through diet or medication can reverse atherosclerosis progression, benefiting patients with angina or bypass surgery.
Area of Science:
- Cardiovascular Medicine
- Medical Interventions
- Atherosclerosis Research
Background:
- Atherosclerosis progression is a significant cardiovascular concern.
- Evidence for atherosclerosis reversibility existed from animal studies and post-mortem findings.
- Clinical proof of atherosclerosis regression in living individuals was needed.
Purpose of the Study:
- To demonstrate that atherosclerosis can regress in living human subjects.
- To evaluate the impact of aggressive cholesterol lowering on atherosclerosis.
- To provide evidence for intervention strategies in cardiovascular disease management.
Main Methods:
- Prospective intervention trials utilizing arteriography in living patients.
- Implementation of aggressive serum cholesterol lowering strategies.
- Utilizing diet alone or a combination of diet and cholesterol-lowering drugs.
Main Results:
- Arteriography confirmed that atherosclerosis can be made to regress.
- The Leiden Intervention Trial and the Cholesterol Lowering Atherosclerosis Study (CLAS) demonstrated atherosclerosis reversal.
- Atherosclerosis growth was retarded and reversed through aggressive cholesterol reduction.
Conclusions:
- Atherosclerosis is a reversible condition in living patients.
- Aggressive cholesterol lowering is effective in regressing established atherosclerotic lesions.
- Lowering cholesterol levels is recommended for patients with angina pectoris and those who have undergone bypass surgery, regardless of baseline levels.