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Pathophysiology of Atherosclerosis

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Mechanisms of Vascular Disease

Abstract

Vascular diseases caused by atherosclerosis remain among the leading causes of mortality and morbidity worldwide and are responsible for enormous health economic burden. Atherosclerosis is a chronic inflammatory disease of blood vessels that can be initiated as early as childhood and develops over decades. It is marked by the formation of lipid-rich plaques that pose risk by their flow-limiting nature and propensity for rupture or erosion and thrombotic occlusion. Its pathophysiology involves numerous different molecular and cellular mediators, including a diverse array of vascular, innate and adaptive immune cell subtypes. This chapter discusses the complex pathogenesis of atherosclerosis and its evolution from early stage fatty streaks to the development of advanced thin cap fibroatheromas that are vulnerable to thrombotic complications.

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Further Reading

  • Galkina E, Kadl A, Sanders J, Varughese D, Sarembock IJ, Ley K. Lymphocyte recruitment into the aortic wall before and during development of atherosclerosis is partially L-selectin dependent. J Exp Med. 2006;203:1273–82.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Hansson GK. Inflammation, atherosclerosis, and coronary artery disease. N Engl J Med. 2005;352:1685–95.

    CAS  PubMed  Google Scholar 

  • Kolaczkowska E, Kubes P. Neutrophil recruitment and function in health and inflammation. Nat Rev Immunol. 2013;13:159–75.

    CAS  PubMed  Google Scholar 

  • Moore KJ, Sheedy FJ, Fisher EA. Macrophages in atherosclerosis: a dynamic balance. Nat Rev Immunol. 2013;13:709–21.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Ridker PM, Stampfer MJ, Rifai N. Novel risk factors for systemic atherosclerosis: a comparison of C-reactive protein, fibrinogen, homocysteine, lipoprotein(a), and standard cholesterol screening as predictors of peripheral arterial disease. JAMA. 2001;285:2481–5.

    CAS  PubMed  Google Scholar 

  • Robbins CS, Hilgendorf I, Weber GF, Theurl I, Iwamoto Y, Figueiredo JL, et al. Local proliferation dominates lesional macrophage accumulation in atherosclerosis. Nat Med. 2013;19:1166–72.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Tabas I. Macrophage death and defective inflammation resolution in atherosclerosis. Nat Rev Immunol. 2010;10:36–46.

    CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Vascular Research Centre, Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia

    Sanuja Fernando, Christina A. Bursill & Peter J. Psaltis

  2. Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia

    Sanuja Fernando, Christina A. Bursill & Peter J. Psaltis

  3. Monash Heart, Monash Medical Centre and Department of Medicine, Monash University, Melbourne, VIC, Australia

    Stephen J. Nicholls

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  1. Sanuja Fernando
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Correspondence to Peter J. Psaltis .

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  1. Discipline of Surgery, The University of Adelaide, Adelaide, SA, Australia

    Robert Fitridge

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Fernando, S., Bursill, C.A., Nicholls, S.J., Psaltis, P.J. (2020). Pathophysiology of Atherosclerosis. In: Fitridge, R. (eds) Mechanisms of Vascular Disease. Springer, Cham. https://doi.org/10.1007/978-3-030-43683-4_2

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  • DOI: https://doi.org/10.1007/978-3-030-43683-4_2

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