CURRENT DIAGNOSIS AND TREATMENT OF ATHEROSCLEROSIS

Current Diagnosis and Treatment of Atherosclerosis
Basher I. Emtebakh
Wright State University
Laboratory Research 2, Spring 2013

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CURRENT DIAGNOSIS AND TREATMENT OF ATHEROSCLEROSIS

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Abstract
Atherosclerosis is a complex inflammatory process that affects the arterial wall. People of different ages are susceptible to developing the disease. It is considered the most common cause of morbidity and mortality in the world. Epithelial injury caused by different risk factors is the initial process of the disease. Nitric oxide liberation, lipid retention, and inflammatory cell proliferation are of significance in the disease pathogenesis. The goal of this review is to better understand the disease process and the role of the atherogenic biomarkers that develop in the affected site during the disease progression. Determining the risk of atherogenic plaque development vulnerability is the main obstacle that faces scientists, followed by making proper diagnosis and choosing treatment. Different imaging techniques, especially the non invasive ones, provide highly useful images to characterize the plaque development. These techniques also contributed to cure many patients at risk of plaque rupture. Prevention and treatment of the disease depend mainly on the proper education of patients and people at risk of developing the disease, and that is done by changing their life style to minimize the risk factors that increase their incidence of getting the disease. Eating healthy food, stopping smoking, and exercising are the main aspects in a prevention program. Additionally, combinations of lipid lowering and antihypertensive medications have been shown to reduce the disease progression by up to 50%.
In summary, this review paper will show that in order to reach the goal of a proper treatment, we must take steps forward into proper assessment and diagnosis of the disease.
Introduction
Atherosclerosis is a complex chronic disease of the arterial blood vessels which is characterized by thickening and hardening of the blood vessel wall as a result of excessive accumulation of cholesterol, inflammatory cells, and calcium precipitation, which lead to

CURRENT DIAGNOSIS AND TREATMENT OF ATHEROSCLEROSIS

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forming hard structures called plaques (Kulbertus, 2012). These plaques block and interrupt the arterial blood supply of the affected area, cause pain, and can decrease the functional activity of the affected organ. Atherosclerosis affects all kinds of arteries, but mainly the large and mediumsized arteries such as the coronary, renal, femoral, cerebral, and carotid arteries. It is a process that starts in childhood and takes long time before it causes serious problems depending on the site of blockage. Examples of serious blockages are: Coronary Artery Disease (CAD) -loss of blood to the heart, Stroke-loss of blood to the brain, or Peripheral Vascular Disease (PAD)- loss of blood supply to the legs. A plague lesion starts when the endothelial layer of the arterial wall becomes damaged. Although the proper control of many risk factors like hypertension, hypercholesterolemia, hyperglycemia, and smoking could reduce the disease incidence, many studies suggest that the role of nitric oxide, oxidative radicals, lipoproteins, and autoimmune response are the main aspects to consider in atherosclerosis prevention and treatment.
Risk factors and Pathogenesis of Atherosclerosis
Endothelial Injury
The contribution of many risk factors such as high cholesterol and triglyceride levels in the blood, high blood pressure, smoking, and diabetes can cause damage to the endothelial layer.
Additionally, other risk factors such as alcohol addiction, lack of exercise, being overweight and family history of hardening of the arteries are shown to increase the incidence of the disease.
Endothelial cells are considered to be the main linkage between the