Epitome of Modifying Factors and an Approach toward Prevention

Abstract

DR. GROEN: The term “arteriosclerosis” is applied to a variety of quite different lesions affecting the vascular (mainly arterial) wall. While the lesions differ from one another in appearance and composition, they often appear to be related as part of a sequence of pathological changes in the tissue. Evidence from experimental studies as well as pathological surveys establish that the different types of lesions may occur together or separately in the same place or in different places, and in vessels of the same individual or of different individuals. Fatty streaks, elevated lesions of fibrous or fatty type, endothelial, subendothelial and elastica changes and accumulation of lipids, sulfated mucopolysaccharides, platelets, muscle cells, fibroblasts, mononuclear cells and rupture, thrombosis, hyalinosis necrosis and calcification all appear to be part of the arteriosclerotic processes. The multiple manifestations of arteriosclerosis appear to be set in motion in a variety of ways. Depending on the different causal processes (alone or in combination), the lesions have different appearances and ways of developing. Apparently a coincidence of many causal factors is operating in most Western human populations. This may explain why the “complicated lesions” are found at a relatively early age in the vessels of heart, brain, kidneys and extremities among these populations.