Atherosclerosis Diet And Drugs

Cardiovascular diseases continue to be the leading cause of death in the - jority of industrialized countries. The most frequent underlying pathology, namely atherosclerosis, and its clinical sequelae, namely coronary heart d- ease, cerebrovascular disease and peripheral artery disease, remain common although for a long time we have been made aware of avoidable or mo- ?able etiological factors such as smoking, fat-rich diet or lack of exercise, and although these adverse lifestyle factors have been extensively addressed by population-wide primary prevention programs. Cardiovascular morbidity and mortality also remain high despite successful anti-hypertensive and lipid lowering drug therapies which help to reduce cardiovascular morbidity and mortality by about 30% in both secondary and tertiary prevention settings. This can partly be explained by the increasing life expectancy and growing p- portionofelderly people,especiallyinEuropeandNorthAmerica. Inaddition, the World Health Organization makes the alarming prediction that probably in response to the spreading of western dietary behavior and lack of exercise resulting in an increasing prevalence of diabetes, dyslipidemia and hypert- sion, cardiovascular diseases rather than infectious diseases will become the most frequent cause of death worldwide. This volume of the Handbook of Experimental Pharmacology entitled “Atherosclerosis” is divided into four parts and intends to give an overview on the pathogenesis of atherosclerosis, established treatment and prevention regimen, and of perspectives for the development of new treatment modalities.

Cardiovascular diseases continue to be the leading cause of death in the - jority of industrialized countries. The most frequent underlying pathology, namely atherosclerosis, and its clinical sequelae, namely coronary heart d- ease, cerebrovascular disease and peripheral artery disease, remain common although for a long time we have been made aware of avoidable or mo- ?able etiological factors such as smoking, fat-rich diet or lack of exercise, and although these adverse lifestyle factors have been extensively addressed by population-wide primary prevention programs. Cardiovascular morbidity and mortality also remain high despite successful anti-hypertensive and lipid lowering drug therapies which help to reduce cardiovascular morbidity and mortality by about 30% in both secondary and tertiary prevention settings. This can partly be explained by the increasing life expectancy and growing p- portionofelderly people,especiallyinEuropeandNorthAmerica. Inaddition, the World Health Organization makes the alarming prediction that probably in response to the spreading of western dietary behavior and lack of exercise resulting in an increasing prevalence of diabetes, dyslipidemia and hypert- sion, cardiovascular diseases rather than infectious diseases will become the most frequent cause of death worldwide. This volume of the Handbook of Experimental Pharmacology entitled “Atherosclerosis” is divided into four parts and intends to give an overview on the pathogenesis of atherosclerosis, established treatment and prevention regimen, and of perspectives for the development of new treatment modalities.

This open access book is supported by the European Atherosclerosis Society Association (EAS). This follow-up edition of the well-received Handbook volume 'Atherosclerosis: Diet and Drugs' reflects the state-of-the-art and most recent developments in atherosclerosis research. Outstanding international experts give a comprehensive overview of the field covering topics, such as improving the treatment focusing on established targets, novel drug developments addressing pre-defined targets, hypothesis-based and hypothesis-free approaches to unravel novel targets.

After the success of the two previous meetings on Typing of Hyperlipoproteinemias, in Milan in 1971 and in Rome in 1972, an important part of each of which was devoted to the discussion of therapy, the Italian Society for the Study of Atherosclerosis, the Institute Superiore di Sanita, and the Fondazione Giovanni Lorenzini planned a special treatment of this important topic. This meeting was held in Rome in November 1973 at the Istituto Superiore di Sanita. On this occasion the most important subjects developed in recent years by the most qualified centers of experimental and clinical research were reported. A broad discussion took place regarding the role of diet in causing or worsening the biohumoral changes and the lesions peculiar to arteriosclerosis, while other distinguished authors reported on the role of diet in delaying or correcting the dyslipidemic state.

In this text, an international group of distinguished scientists expose the fallacy and commercial exploitation that has resulted in the developments of, for example, regulatory agencies turning a blind eye to fraudulent claims by manufacturers of margarine, vegetable oil and crisps.

This volume comprises the proceedings of the sixth International Symposium on Drugs Affecting Lipid Meta bolism. Since the first of these symposia in 1960 these triennial meetings have been devoted to the exploration of new ideas, new data and new concepts related to lipid metabolism and atherosclerosis. The sixth Meeting was particularly stimulating in this regard. The concept of the "protective" action of HDL was thoroughly explored within the framework of its molecular biology with data on its epidemiological as well as its in vitro mechan ism(s) of action being discussed. The action of drugs on arterial and HDL metabolism was also discussed as were newer aspects of platelet aggregation, especially as related to prostaglandins. New ground was also broken in discussions of lipid mobilization and mechan isms of hypocholesteremia. We are indebted to the many organizations who con tributed generously to the support of this meeting. Among the sponsors, the assistance of the Lorenzini Foundation was especially helpful. As in all meetings of this type, the hard work of the local organizing committee was instrumental in its success. We are grateful to Mrs. Caroline Hyatt and Mr. Ralph Hollerorth for their invaluable help in the secretariat. We are also deeply indebted to Miss Jane T. Kolimaga for her expert assistance in the preparation of this volume. David Kritchevsky Rodolfo Paoletti William L. Holmes vii Contents LIPOPROTEINS AND DRUGS Lipoprotein Metabolism - New Insights from Cell Biology. . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 D. Steinberg Lipoprotein Metabolism in Man. . . . . . . . . . . . . . . . . . . .