Atherosclerosis is a chronic and often progressive disease of the wall
of the arterial vasculature. The term atherosclerosis is derived from
the Greek words “athero” meaning gruel or paste and “skleros” meaning
stiff or hard. Atherosclerosis is considered a major clinical problem,
which underlies most ischemic events of both the heart as well as the
brain. It is the result of the Western lifestyle and can start very
early in life even in persons without a strong genetic disposition like
untreated familial hypercholesteremia. From the second decade onwards,
the disease progresses more rapidly. The clinical silence of
atherosclerosis is often broken between the 3rd and 5th decade, when
patients present with ischemic complaints of e.g. heart and brain.
Despite the continuing decrease in cardiovascular disease (CVD)
associated death over the last decade, it still is one of the main
causes of death in The Netherlands, accounting for 30,7% of total deaths
in 2007. As a result, the socio-economic consequences remain huge. It
has been estimated that in the European Union annual CVD-associated
costs are €169 billion, of which €105 billion are costs directly related
to healthcare.
Historically, atherosclerosis was simply considered as an accumulation
of lipids in the vascular wall. In the late 90’s, Russell Ross proposed a
major revision of this theory, and these days the perspective of
atherosclerosis as a complicated lipid-driven inflammatory disease is
widely accepted. Lipid metabolism and inflammation mutually influence
each other yielding the complete spectrum of atherosclerotic disease
progression. This is reflected in the correlation between future
cardiovascular events and the combined values of cholesterol, as
indicator of lipid status, and CRP, as indicator of systemic
inflammatory activity. Since CRP levels reflect systemic inflammatory
activity, this notion underscores the role of immunity in human
atherosclerosis.http://repub.eur.nl/res/pub/30551/111123_Segers%2C%20Dolf.pdf
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