One source of great mortality and morbidity in Europe and North America is the cardiovascular disease, Atherosclerosis. It is recognized as a chronic inflammatory disease of the intermediate and large arteries characterized by the thickening of the arterial wall and is the primary cause of coronary and cerebrovascular heart disease (Wilson, 2005). It accounts for 4.35 million deaths in Europe and 35% death in the UK each year. Mortality rate are generally higher in men than pre-menopausal woman. Past the menopause, a woman’s risk is similar to a man’s (George and Johnston, 2010). Clinical trials have confirmed that lipid accumulation, endothelial dysfunction, cell proliferation, inflammation matrix alteration and foam cell formation are characteristic features of the earliest pathogenesis of atherosclerotic disease, and that therapies targeted towards the treatment of those conditions are beneficial (Varghese et al 2005). This essay will summarise the development and factors predispose to atherogenesis, and discuss how the comprehension of cell and molecular based mechanism has led to novel therapies for atherosclerosis.
Atherosclerosis is a disease in which plaque builds up inside the arteries. Arteries are blood vessels that carry oxygen-rich blood to the heart and other parts of your body. It develops by the accumulation of excess Low Density Lipoprotein (LDL) in the arterial wall causing damage to the vascular endothelium which increases expression of adhesion molecules that latch onto monocytes and T cells and decreases the ability of the endothelial cells to release Nitric oxide (NO). Monocytes and LDL accumulates at the site of injury then penetrates the intima where monocytes differenciate to become macrophages and the ...
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... Francis Group: London Edited by Joseph Loscalzo
Serruys P. W, Gershlick A. H (2005)’ Handbook of drug-eluting stents’ Taylor and francis group: Oxonia
Stancu C and Sima A (2001) Statins: mechanism of action and effects Published in J.Cell.Mol.Med. Vol 5, No 4, 2001 pp. 378-387
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Wilson P. W. F. (2005) Molecular Mechanisms of Atherosclerosis Taylor and Francis Group: London Edited by Joseph Loscalzo
Coronary artery disease is a heart disease characterized by narrow arteries and restricted blood flow in arteries and is the major cause of morbidity and mortality globally.[1] According to WHO estimation, 6.8% in men and 5.3% in women are affected globally.[2-4] Cardiovascular disease account for 29% of all deaths in Canada; of all the cardiovascular death, 54% and 23% was due to ischemic heart disease and heart attack, respectively. The total costs for heart disease and stroke were more than $20.9 billion every year. [5,6] With more than 1 artery impacted, multivessel coronary artery disease is more complex and more likely accompanied by other comorbidities including diabetes or high blood pressure; multivessel coronary artery disease usually is more difficult to deal with, has worse prognosis and cost more compared with single coronary artery disease. [7]
Bursill, C. A., Channon, K. M., & Greaves, D. R. (2004). The role of chemokines in atherosclerosis: recent evidence from experimental models and population genetics.Current Opinion in Lipidology. 15, 145-149.
Cardiovascular Diseases (CVD) are the currently the leading cause of death globally for both men and women accounting for 21.9 per cent of total deaths and is projected to increase to 26.3 per cent by 2030 . Statins are the treatment of choice for the primary and secondary prevention of cardiovascular disease and in the management of hypercholesterolaemia because of their proven efficacy and safety profile. Evidences are showing their effectiveness in reduction of cholesterol synthesis and number of pleiotropic effects, which may be cholesterol dependent and cholesterol independent. The present review focus on the origin, properties and effects of statins on endothelial function ( non lipid action of statins) through the increase of endogenous production of NO in different pathways.
Atherosclerosis is the buildup of fatty material called plaque along the walls of the arteries. This causes arteries to become narrowed and less flexible.
In today’s society, people are gaining medical knowledge at quite a fast pace. Treatments, cures, and vaccines for various diseases and disorders are being developed constantly, and yet, coronary disease remains the number one killer in the world.
Lipid altering drugs include several classes of medications each of which have their own mechanism of action. Statins inhibit HMG CoA reductase (hydroxymethylglutaryl CoA reductase), which is the rate-limiting enzyme for the production of cholesterol in the liver. Statins competitively inhibit this enzyme and induce an increased expression of LDL receptors in the liver. Which in turn increases the uptake catabolism of serum LDL into the liver resulting in decreased serum cholesterol level. This reduction in serum LDL and cholesterol levels has resulted in reduction of 10-year CHD and stroke risk. Pitavastatin was approved in Japan since 2003 and was granted FDA approval in 2009 and is marketed under the name of Livalo. Several phase III and IV trials have shown that Pitavastatin is both safe and efficacious in lowering both serum LDL and Triglycerides (TG) by 29.1% and 22.7% respectively from baseline levels which was significant. These studies showed that only 10% of Pitavastatin treated patients had adverse events (AE) in which 84% of these events were mild and about 1% were serious adverse events (SAE)6, 12, 14, 16-26, 28-31. Atorvastatin is the most commonly used statin in clinical practice; the F...
Whether it is Lipitor being used to lower cholesterol or aspirin to lower blood pressure, until the present, cardiovascular and heart diseases have been tackled by a variety of medications that address its various risk factors. However, this strategy focuses on secondary and tertiary prevention instead of heart diseases’ underlying causes. Yes, diabetes mellitus and hypertension have a concrete proven link to heart disease, but addressing them with medication only masks them and does not address the root of the problem.
The hereditary risk factors for cardiovascular disease are primarily those of which individuals are unable to control, the ones for which they are born with. These risk factors would include an individual’s sex, race, age, and genetics. One out of every five males has some form of cardiovascular disease and the same applies for females. More women than men have cardiovascular disease in this country, but this is only due to the fact that there are more women within the U.S. population (Weiss and Lonnquist, 2011). Men percentage wise are at a higher risk than women. There is a somewhat reduced probability for females to have cardiovascular disease before menopause. This is believed by medical researchers and scientists to be directly related to the natural hor...
CHD is primarily due to atherosclerosis, which is the blockage of blood flow in the arteries due to the accumulation of fats, cholesterol, calcium and other substances found in the blood. Atherosclerosis takes place over many years, but when the blood flow becomes so limited due to the build up of plaque in the arteries, there becomes a serious problem. “When...
Liao, J. K., (2007). Safety and efficacy of statins in Asians. American Journal of Cardiology, 99(3), 410-414. doi: 10.1016/j.amjcard.2006.08.051
These inflamed cells are unable to make the normal amounts of antithrombic and vasodilating cytokines. Adhesion molecules that bind macrophages and other inflammatory and immune cells are expressed by inflamed endothelial cells. Many inflammatory cytokines and enzymes are released when macrophages adhere to the injured endothelium, which cause further injury to the vessel wall. The inflammation process creates toxic oxygen radical that cause oxidation of the LDL that have built up in the vessel intima. When LDL is oxidized it promotes added adhesion molecule expression with the recruitment of monocytes that differentiate into macrophages that will consume oxidized LDL when they infiltrate into the tunic intima. A lesion is then formed when the lipid-laden macrophages (foam cells) build up in large amounts. These lesions, also called fatty streaks, are found on the arterial walls of most people and is what defines the second step of atherosclerosis. Fatty streaks create more toxic oxygen radicals, recruit T cells that lead to autoimmunity, and release additional inflammatory mediators that will cause increased damage to the arterial
Cardiovascular disease is currently the leading cause of death in the United States. It is responsible for one in four deaths every year, about 600,000 mortalities. This disease affects men and women, as well as every ethnic group. Coronary artery disease is the most common cardiovascular disease, representing approximately 400,000 deaths per year of the aforementioned 600,000 total deaths from cardiovascular diseases as a whole. In 2010 alone, coronary artery disease cost the United States $108.9 billion for health care services, medication, and lost productivity. These chilling statistics, published every year by the American Medical Association, demonstrate the immediate need for new and innovative ways to prevent, detect, and treat coronary heart disease. This paper will explore the molecular biology behind the disease while explaining the current treatments and prevention that are available today, why they work and what can be done to improve them.
Artherosclerosis is characterized by fatty deposits that develop as streaks inside the lining of arteries and some streaking can be found in teenagers and then by an increasing proportion of the population from then on. If you were to ask the experts what causes arteriosclerosis the answer would depend on the expert. Researchers do not agree on the causation but they have agreed on possible risk factors such as smoking, a high fat diet, high cholesterol levels, high blood pressure, high iron levels, inflammation and bad genes. None of which appear to be the primary cause because if you were to eliminate one possible cause you should eliminate the disease. Many researchers have begun to think that many diseases including cancers originate as a composite of risk factors and that approach does not make sense because it suggests that Human arteries are so fragile that any one or combination of the...
Coronary Heart Disease (CHD) is the leading cause of death in the United States. 13 million people are affected by this disease. CHD is also called Hardening of the Arteries, CAD. CHD is cause by the build-up of plaque in the arteries that connect to the heart. The build-up is caused by fat materials and other substances that form plaque. The plaque builds-up on the wall of the coronary arteries. The coronary arteries are responsible of the blood flow and oxygen that gets to the heart. The build-up of the fat materials causes the arteries to get narrow, this results in the blood flow and oxygen to the heart to slow down or even stop.
Atherosclerosis is a disease that occurs when arteries become blocked, inflamed, or hardened. As a result of this, blood cannot easily pass through the artery, and blood pressure increases. Many people suffer from atherosclerosis as they age, but young people can be affected by atherosclerosis also. There are many preventative steps that can be taken to decrease the risk of atherosclerosis; however, if atherosclerosis does develop in the arteries, medications can be given to help the individual receive adequate blood flow to important tissues. Atherosclerosis is a very serious condition that requires medical attention and a change in life style because it is a precursor to many dangerous and potentially fatal diseases.