This review assesses the current status of knowledge concerning the relationship of risk factors to atherosclerotic lesions. Risk factors for atherosclerotic lesions per se need not necessarily be identical to those related to clinically overt coronary heart disease (CHD). This review is based on 1) autopsy studies where information on risk factors was gathered In a retrospective fashion; and 2) autopsy studies where information on risk fetors was gathered prospectively. In spite of differences in study designs and grading methods among the studies, the general findings were similar. Elevated serum cholesterol and blood pressure are positively and significantly related to atherosclerotic lesions. High density llpoprotein cholesterol Is inversely related to coronary and probably also to cerebral atherosclerosis. Almost all studies Indicate a significant association between cigarette smoking and degree of aortic atherosclerosis; a positive relationship between smoking and coronary atherosclerosis Is found In many, but not all, studies. In most studies no consistent association was found between obesity or physical activity and the degree of atherosclerosis. Data from the Community Pathology Study in New Orleans indicate that the average extent of coronary atherosclerosis in a population may be subject to changes within a relatively short period of time; these changes might be expected to parallel changes In risk factors In the population. (Arteriosclerosis 3:187-198, May/June 1983) E pidemiologic studies of living populations have identified personal attributes associated with increased risk of developing coronary heart disease (CHD). The clinical endpoints for CHD (myocardial infarction, sudden death due to coronary thrombosis, and angina pectoris) are the result of a combination of factors, including the amount and distribution of coronary atherosclerosis, mechanisms related to the occlusive episode, the size and workload of the heart, and sequelae such as cardiac arrhythmias and myocardial failure. The close relationship between severity and extent of coronary atherosclerosis and the development fo CHD is now almost universally accepted; nevertheless, it is important to establish whether risk factors for clinically overt CHD are also related to the development of atherosclerosis per se.1 Risk factors for CHD could be associated This research was supported in part by Grant HL-08974 from the National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Public Health Service.Address for reprints: Dr. Jack P. Strong, Department of Pathology, Louisiana State University Medical Center, 1901 Perdido Street, New Orleans, Louisiana 70112. 'Received December 11, 1982; revision accepted February 8, 1983. with the basic development of the underlying arterial lesions or with the complications of lesions, such as thrombosis, hemorrhage, rupture of plaques, and embolism. Risk factors could also act directly on the myocardium and its conduction system, not on the underlying arterial lesions. The detection ...
SUMMARYThe distribution of fatty streaks, fibrous plaques, complicated lesions, and calcified lesions were determined for each of five segments in the common carotid arteries, each of five segments of internal carotid arteries, and for each of seven segments of vertebral arteries in specimens from 961 autopsied cases in Oslo, Norway, and Guatemala.
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