Skip to main content
SpringerLink
Log in

Lipoproteins and Diet in the Pathogenesis of Atherosclerosis

  • Chapter
Tobacco Smoking and Atherosclerosis

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 273))

  • 177 Accesses

Abstract

Atherosclerotic cardiovascular disease is a major cause of mortality and morbidity in Western countries, leading to 759,000 deaths annually in the United States1. The pathogenesis of atherosclerosis is complex, multifactorial, and involves both environmental and genetic risk factors. Steinberg2 schematically illustrated the proposed interplay of blood factors with arterial wall responses (Figure 1). Since many of these factors are discussed elsewhere,3 this review will focus on the central role of lipoproteins in atherosclerosis. Specifically, this review will examine the evidence linking dietary cholesterol and fat intake to serum lipoproteins and coronary heart disease (CHD), the strength of the relationships between atherosclerosis and serum lipoproteins, clinical trials focusing on lowering serum lipoproteins to reduce risk for CHD, animal and human regression studies, the effects of dietary fiber on serum lipoproteins and CHD, and practical implications.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. U.S. Department of Health and Human Services, “The Surgeon General’s Report on Nutrition and Health,” U.S. Government Printing Office, Washington (1988).

    Google Scholar 

  2. D. Steinberg, Lipoproteins and atherosclerosis: a look back and a look ahead, Arteriosclerosis 3:283 (1983).

    Article  PubMed  CAS  Google Scholar 

  3. J.W. Anderson, D.A. Deakins, T.L. Floore, B.M. Smith, and S.E. Whitis, Dietary fiber and coronary heart disease, CRC Reviews, in press.

    Google Scholar 

  4. N. N. Anitschkow, A history of experimentation on arterial atherosclerosis in animals, in: “Cowdry’s Arteriosclerosis: A Survey of the Problem,” C.C. Thomas, Springfield (1967).

    Google Scholar 

  5. M.G. Bond, B.C. Bullock, D.A. Bellinger, and T.E. Hamm, Myocardial infarction in a large colony on nonhuman primates with coronary artery atherosclerosis, Am. J. Pathol. 101:675 (1980).

    PubMed  CAS  Google Scholar 

  6. R.W. Wissler, Principles of the pathogenesis of atherosclerosis, in: “Heart Disease: A Textbook of Cardiovascular Medicine,” E. Braunwald, ed., W.B. Saunders Company, Philadelphia (1984).

    Google Scholar 

  7. A. Keys, “Seven Countries: A Multivariate Analysis of Death and Coronary Heart Disease,” Harvard University Press, Cambridge (1980).

    Google Scholar 

  8. A.C. Arntzenius, D. Kromhout, J.D. Barth, J.H.C. Reiber, A.V.G. Bruschke, B. Buis, C.M. van Gent, N.Kempen-Voogd, S. Strikwerda, and E.A. van der Velde, Diet, lipoproteins, and the progression of coronary atherosclerosis New Engl. J. Med. 312:805 (1985).

    Article  PubMed  CAS  Google Scholar 

  9. M.L. Armstrong, E.D. Warner, and W. E. Connor, Regression of coronary atheromatosis in Rhesus monkeys, Circulation Res. 27:59 (1970).

    PubMed  CAS  Google Scholar 

  10. T.B. Clarkson, M.G. Bond, B. C. Bullock, K.J. McLaughlin, and J.K. Sawyer, A study of atherosclerosis regression in Macaca mulatta, Exp. Mol. Pathol. 41:96 (1984).

    Article  PubMed  CAS  Google Scholar 

  11. C.J. Glueck, D.J. Gordon, J.J. Nelson, C.E. Davis, and H. A. Tyroler, Dietary and other correlates of changes in total and low density lipoprotein cholesterol in hypercholesterolemic men: the lipid research clinics coronary primary prevention trial, Am. J. Clin. Nutr. 44:489 (1986).

    PubMed  CAS  Google Scholar 

  12. F.M. Sacks, J. Salazar, L. Miller, J.M. Foster, M. Sutherland, K.W. Samonds, J.J. Albers, and E.H. Kass, Ingestion of egg raises plasma low density lipoproteins in free-living subjects, Lancet 1:647 (1984).

    Article  PubMed  CAS  Google Scholar 

  13. J. Stamler and R. Shekelle, Dietary cholesterol and human coronary heart disease: the epidemiologic evidence, Arch. Pathol. Lab. Med. 112:1032 (1988).

    PubMed  CAS  Google Scholar 

  14. W.E. Connor, and S.L. Connor, The key role of nutritional factors in the prevention of coronary heart disease, Prev. Med. 1:49 (1972).

    Article  PubMed  CAS  Google Scholar 

  15. A. Keys, Diet, in: “Seven Countries: A Multivariate Analysis of Death and Coronary Heart Disease,” Harvard University Press, Cambridge (1980).

    Google Scholar 

  16. D.M. Hegsted, and L.M. Ausman, Diet, alcohol and coronary heart disease in men, J. Nutr. 118:1184 (1988).

    PubMed  CAS  Google Scholar 

  17. Inter-Society Commission for Heart Disease Resources, Optimal resources for primary prevention of atherosclerotic disease, Circulation 70:153A (1984).

    Article  Google Scholar 

  18. J. Stamler, D. Wentworth, and J.D. Neaton, Is relationship between serum cholesterol and risk of premature death from coronary heart disease continuous and graded?, JAMA 256:2823 (1986).

    Article  PubMed  CAS  Google Scholar 

  19. Consensus Conference, Lowering blood cholesterol to prevent heart disease, JAMA 253:2080 (1985).

    Article  Google Scholar 

  20. S.M. Grundy, Cholesterol and coronary heart disease: a new era, JAMA 256:2849 (1986).

    Article  PubMed  CAS  Google Scholar 

  21. W.B. Kannel, W.P. Castelli and T. Gordon, Cholesterol in the prediction of atherosclerotic disease, Ann. Intern. Med. 90:85 (1979).

    PubMed  CAS  Google Scholar 

  22. The Pooling Project Research Group, Relationship of blood pressure, serum cholesterol, smoking habit, relative weight, and ECG abnormalities to incidence of major coronary events: Final report of the Pooling Project, J. Chron. Dis. 31:201 (1978).

    Article  Google Scholar 

  23. C. Aravanis, The classic risk factors for coronary heart disease: experience in Europe, Prev. Med. 12:16 (1983).

    Article  PubMed  CAS  Google Scholar 

  24. N. Rifai, Lipoproteins and apolipoproteins: composition, metabolism and association with coronary heart disease. Arch. Pathol. Lab. Med. 110:694 (1986).

    PubMed  CAS  Google Scholar 

  25. W. P. Castelli, J.T. Doyle, T. Gordon, C.G. Hames, M.C. Hjortland, S.B. Hulley, A. Kagan, and W.J. Zukel, HDL cholesterol and other lipids in coronary heart disease: The Cooperative Lipoprotein Phenotyping Study, Circulation 55:767 (1977).

    PubMed  CAS  Google Scholar 

  26. The Lipid Research Clinics Program, The Lipid Research Clinics Coronary Primary Prevention Trial Results: reduction in incidence of coronary heart disease, JAMA 251:351 (1984).

    Article  Google Scholar 

  27. D.J. Gordon, and B.M. Rifkind, High-density lipoprotein — the clinical implications of recent studies, New Engl. J. Med. 321:1311 (1989).

    Article  PubMed  CAS  Google Scholar 

  28. W.B. Kannel, High-density lipoproteins: epidemiologic profile and risks of coronary artery disease, Am. J. Cardiol. 52:9B (1983).

    Article  PubMed  CAS  Google Scholar 

  29. H. Aberg, H. Lithell, I. Selinus, and H. Hedstrand, Serum triglycerides are a risk factor for myocardial infarction but not for angina pectoris, Atherosclerosis 54:89 (1985).

    Article  PubMed  CAS  Google Scholar 

  30. T. Gordon, W.P. Castelli, M.C. Hjortland, W.B. Kannel, and T.R. Dawber, High density lipoprotein as a protective factor against coronary heart disease: the Framingham Study, Am. J. Med. 62:707 (1977).

    Article  PubMed  CAS  Google Scholar 

  31. K.M. West, M.M.S. Ahuja, P.H. Bennett, A. Czyzyk, O. Mateo De Acosta, J.H. Fuller, B. Grab, V. Grabauskas, R.J. Jarrett, K. Kosaka, H. Keen, A.S. Krolewski, E. Miki, V. Schliack, A. Teuscher, P.J. Watkins, and J.A. Stober, The role of circulating glucose and triglyceride concentrations and their interactions with other “risk factors” as determinants of arterial diseae in nine diabetic population samples from the WHO multinational study, Diabetes Care 6:361 (1983).

    Article  PubMed  CAS  Google Scholar 

  32. D.B. Zilversmit, Atherogenesis: a postprandial phenomenon, Circulation 60:473 (1979).

    PubMed  CAS  Google Scholar 

  33. B.H. Chung, J.P. Segrest, K. Smith, F.M. Griffin, and C.G. Brouillette, Lipolytic surface remnants of triglyceride-rich lipoproteins are cytotoxic to macrophages but not in the presence of high density lipoprotein, J. Clin. Invest. 83:1363 (1989).

    Article  PubMed  CAS  Google Scholar 

  34. J.S. Cohn, J.R. McNamara, S.D. Cohn, J.M. Ordovas, and E.J. Schaefer, Postprandial plasma lipoprotein changes in human subjects of different ages, J. Lipid Res. 29:469 (1988).

    PubMed  CAS  Google Scholar 

  35. R.J. Havel, Early effects of fat ingestion on lipids and lipoproteins of serum in man, J. Clin. Invest. 36:848 (1957).

    Article  PubMed  CAS  Google Scholar 

  36. T.G. Redgrave, and L.A. Carlson, Changes in plasma very low density and low density lipoprotein content, composition, and size after a fatty meal in normo- and hypertriglyceridemic man, J. Lipid Res. 20:217 (1979).

    PubMed  CAS  Google Scholar 

  37. G.R. Castro, and C.J. Fielding, Effects of postprandial lipemia on plasma cholesterol metabolism, J. Clin. Invest. 75:874 (1985).

    Article  PubMed  CAS  Google Scholar 

  38. I. Hjermann, K. Velve Byre, I. Holmf, P. Leren, Effect of diet and smoking intervention on the incidence of coronary heart disease, Lancet 2:1303 (1981).

    Article  PubMed  CAS  Google Scholar 

  39. Lipid Research Clinics Program, The Lipid Research Clinics Coronary Primary Prevention Trial Results: the relationship of reduction in incidence of coronary heart disease to cholesterol lowering, JAMA, 251:365 (1984).

    Article  Google Scholar 

  40. M.H. Frick, O. Elo, K. Haapa, O.P. Heinonen, P. Heinsalmi, P. Helo, J.K. Huttunen, P. Kaitaniemi, P. Koskinen, V. Manninen, H. Maenpaa, M. Malkonen, M. Manttari, S. Norola, A. Pasternack, J. Pikkarainen, M. Romo, T. Sjoblom, and E.A. Nikkila, Helsinki Heart Study: primary-prevention trial with gemfibrozil in middle-aged men with dyslipidemia, N. Engl. J. Med. 317:1237 (1987).

    Article  PubMed  CAS  Google Scholar 

  41. Committee of Principal Investigators, A co-operative trial in the primary prevention of ischaemic heart disease using Clofibrate, Br. Heart J. 40:1069 (1978).

    Article  Google Scholar 

  42. L. Wilhelmsen, G. Berglund, D. Elmfeldt, G. Tibblin, H. Wedel, K. Pennert, A. Vedin, C. Wilhelmsson, and L. Werko, The multifactor primary prevention trial in Goteborg, Sweden, Eur. Heart J. 7:279 (1986).

    PubMed  CAS  Google Scholar 

  43. D.H. Blankenhorn, S.A. Nessim, R. L. Johnson, M.E. Sanmarco, S.P. Azen, and L. Cashin-Hemphill, Beneficial effects of combined Colestipol-Niacin therapy on coronary atherosclerosis and coronary venous bypass grafts, JAMA 257:3233 (1987).

    Article  PubMed  CAS  Google Scholar 

  44. B.G. Brown, E.L. Bolson, C.D. Pierce, R.B. Peterson, and H.T. Dodge, Regression of atherosclerosis in man: current data and their methodological limitations, in: “Regression of Atherosclerotic Lesions - Experimental Studies and Observations in Humans,” M. R. Malinow and V. H. Blaton, eds., Plenum Press, New York (1984).

    Google Scholar 

  45. D.H. Blankenhorn, R.L. Johnson, W.J. Mack, H.A. El Zein, and L. I. Vailas, The influence of diet on the appearance of new lesions in human coronary arteries, JAMA 263:1646 (1990).

    Article  PubMed  CAS  Google Scholar 

  46. C.J. Lavie, G.T. Gau, R.W. Squires, and B. A. Kottke, Management of lipids in primary and secondary prevention of cardiovascular diseases. Mayo Clin. Proc. 63:605 (1988).

    PubMed  CAS  Google Scholar 

  47. J.F.Brensike, R.I. Levy, S.F. Kelsey, E.R. Passamani, J.M. Richardson, I.K. Loh, N.J. Stone, R.F. Aldrich, J.W. Battaglini, D. J. Moriarty, M.R. Fisher, L. Friedman, W. Friedewald, K.M. Detre, and S.E. Epstein, Effects of therapy with cholestyramine on progression of coronary arteriosclerosis: results of the NHLBI Type II Coronary Intervention Study, Circulation 69:313 (1984).

    Article  PubMed  CAS  Google Scholar 

  48. A. Keys, F. Grande, and J.T. Anderson, Fiber and pectin in the diet and serum cholesterol concentration in man, Proc. Soc. Exp. Biol. Med. 106:555 (1961).

    PubMed  CAS  Google Scholar 

  49. J.E. Garvin, D.T. Forman, W.R. Eiseman, and C.R. Phillips, Lowering of human serum cholesterol by an oral hydrophylic colloid, Proc. Soc. Exp. Biol. Med. 120:744 (1965).

    PubMed  CAS  Google Scholar 

  50. J.W. Anderson, N. Zettwoch, T. Feldman, J. Tietyen-Clark, P. Oeltgen, and C.W. Bishop, Cholesterol-lowering effects of psyllium hydrophilic mucilloid for hypercholesterolemic men, Arch. Intern. Med. 148:292 (1988).

    Article  PubMed  CAS  Google Scholar 

  51. A.P. DeGroot, R. Luyken, and N.A. Pikaar, Cholesterol-lowering effect of rolled oats, Lancet 2:303 (1963).

    Article  CAS  Google Scholar 

  52. D.J.A. Jenkins, D. Reynolds, B. Slavin, A.R. Leeds, A.L. Jenkins, and E.M. Jepson, Dietary fiber and blood lipids: treatment of hypercholesterolemia with guar crispbread, Am. J. Clin. Nutr. 33:575 (1980).

    PubMed  CAS  Google Scholar 

  53. J.W. Anderson, and N. J. Gustafson, Alternative lipid-lowering diets, Practical Cardiology 14:84 (1988).

    Google Scholar 

  54. J.W. Anderson, L. Story, B. Sieling, W.-J.L. Chen, M.S. Petro, and J. Story, Hypocholesterolemic effects of oat-bran or bean intake for hypercholesterolemic men, Am. J. Clin. Nutr. 40:1146 (1984).

    PubMed  CAS  Google Scholar 

  55. J.W. Anderson, W.-J.L. Chen, and B. Sieling, Hypolipidemic effects of high-carbohydrate, high-fiber diets, Metabolism 29:551 (1980).

    Article  PubMed  CAS  Google Scholar 

  56. T. Gordon, A. Kagan, M. Garcia-Palmieri, W.B. Kannel, W.J. Zukel, J. Tillotson, P. Sorlie, and M. Hjortland, Diet and its relation to coronary heart disease and death in three populations, Circulation 63:500 (1981).

    Article  PubMed  CAS  Google Scholar 

  57. M.R. Garcia-Palmieri, P. Sorlie, J. Tillotson, R. Costas, E. Cordero, and M. Rodriguez, Relationship of dietary intake to subsequent coronary heart disease incidence: the Puerto Rico Heart Health Program, Am. J. Clin. Nutr. 33:1818 (1980).

    PubMed  CAS  Google Scholar 

  58. D.L. McGee, D.M. Reed, K. Yano, A. Kagan, and J. Tillotson, Ten-year incidence of coronary heart disease in the Honolulu Heart Program, Am. J. Epidemiol. 119:667 (1984).

    PubMed  CAS  Google Scholar 

  59. J.W. Anderson, Plant fiber and blood pressure, Ann. Intern. Med. 98:842 (1983).

    PubMed  CAS  Google Scholar 

  60. J.W. Anderson and K. Ward, High-carbohydrate, high-fiber diets for insulin-treated men with diabetes mellitus, Am. J. Clin. Nutr. 32:2312 (1979).

    PubMed  CAS  Google Scholar 

  61. H.C.R. Simpson, R.W. Simpson, S. Lousley, R.D. Carter, M. Geekie, T.D.R. Hockaday, and J.I. Mann, A high carbohydrate leguminous fibre diet improves all aspects of diabetic control, Lancet 1:1 (1981).

    Article  PubMed  CAS  Google Scholar 

  62. L. Story, J.W. Anderson, W.-J.L. Chen, D. Karounos, and B. Jefferson, Adherence to high-carbohydrate, high-fiber diets: long-term studies of non-obese diabetic men, J. Am. Diet. Assoc. 85:1105 (1985).

    PubMed  CAS  Google Scholar 

  63. M. Krotkiewski, Effect of guar gum on body-weight, hunger ratings and metabolism in obese subjects, Br. J. Nutr. 52:97 (1984).

    Article  PubMed  CAS  Google Scholar 

  64. J.W. Anderson, and C.A. Bryant, Dietary fiber: diabetes and obesity, Am. J. Gastroenterol. 81:898 (1986).

    PubMed  CAS  Google Scholar 

  65. D. Kromhout, E.B. Bosschieter, and C.D.L. Coulander, Dietary fibre and 10-year mortality from coronary heart disease, cancer, and all causes, Lancet 2:518 (1982).

    Article  PubMed  CAS  Google Scholar 

  66. J.N. Morris, J.W. Marr, and D.G. Clayton, Diet and heart: a postscript, Br. Med. J. 2:1307 (1977).

    Article  PubMed  CAS  Google Scholar 

  67. L.H. Kushi, R.A. Lew, F.J. Stare, C.R. Ellison, M.E. Lozy, G. Bourke, L. Daly, I. Graham, N. Hickey, R. Mulcahy, and J. Kevaney, Diet and 20-year mortality from coronary heart Disease. The Ireland-Boston Diet-Heart Study, New Engl. J. Med. 312:811 (1985).

    Article  PubMed  CAS  Google Scholar 

  68. K.-T. Khaw and E. Barrett-Connor, Dietary fiber and reduced ischemic heart disease mortality rates in men and women: a 12-year prospective study, Am. J. Epidemiol. 126:1093 (1987).

    PubMed  CAS  Google Scholar 

  69. J. Hallfrisch, J. D. Tobin, D. C. Muller, and R. Andres, Fiber Intake, Age, and Other Coronary Risk Factors in Men of the Baltimore Longitudinal Study (1959–1975), J. Gerontology: Med. Sci. 43:M64 (1988).

    CAS  Google Scholar 

  70. D. Kromhout and C. de Lezenne Coulander, Diet, prevalence and 10-year mortality from coronary heart disease in 871 middle-aged men: the Zutphen Study, Am. J. Epidemiol. 119:733 (1984).

    PubMed  CAS  Google Scholar 

  71. The Expert Panel, Report of the National Cholesterol Education Program Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults, Arch. Intern. Med. 148:36 (1988).

    Article  Google Scholar 

  72. Study Group, European Atherosclerosis Society, Strategies for the prevention of coronary heart disease: a policy statement of the European Atherosclerosis Society, Eur. Heart J. 8:77 (1987).

    Google Scholar 

  73. The Canadian Consensus Conference on the Prevention of Heart and Vascular Disease by Altering Serum Cholesterol and Lipoprotein Risk Factors, Canadian Consensus Conference on Cholesterol: A final report, Can. Med. Assoc. J. 139:1 (1988).

    Google Scholar 

  74. A Joint Statement of the Nutrition Committee and the Council on Arteriosclerosis, Recommendations for treatment of hyperlipidemia in adults, Circulation 69:1065A (1984).

    Google Scholar 

  75. L.-G. Ekelund, W.L. Haskell, J.L. Johnson, F.S. Whaley, M.H. Criqui, and D.S. Sheps, Physical fitness as a predictor of cardiovascular mortality in asymptomatic North American men, N.Engl. J. Med. 319:1379 (1988).

    Article  PubMed  CAS  Google Scholar 

  76. P.D. Wood, W.L. Haskell, H. Klein, S. Lewis, M.P. Stern, and J.W. Farquhar, The distribution of plasma lipoproteins in middle-aged male runners, Metabolism 25:1249 (1976).

    Article  PubMed  CAS  Google Scholar 

  77. J.W. Anderson, W.-J.L. Chen, and B. Sieling, Hypolipidemic effects of high-carbohydrate, high-fiber diets, Metabolism 29:551 (1980).

    Article  PubMed  CAS  Google Scholar 

  78. J.W. Anderson, and N.J. Gustafson, Dietary fiber and heart disease: current management concepts and recommendations, Top. Clin. Nutr. 3:21 (1988).

    Google Scholar 

  79. J.W. Anderson, “Be Heart Smart”, The HCF Nutrition Research Foundation, Inc., Lexington (1989).

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Metabolic Research Group, V.A. Medical Center, University of Kentucky, Lexington, Kentucky, USA

    James W. Anderson & Tammy L. Floore

Authors
  1. James W. Anderson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tammy L. Floore
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Tobacco and Health Research Institute, University of Kentucky, Lexington, Kentucky, USA

    John N. Diana

Rights and permissions

Reprints and permissions

Copyright information

© 1990 Plenum Press, New York

About this chapter

Cite this chapter

Anderson, J.W., Floore, T.L. (1990). Lipoproteins and Diet in the Pathogenesis of Atherosclerosis. In: Diana, J.N. (eds) Tobacco Smoking and Atherosclerosis. Advances in Experimental Medicine and Biology, vol 273. Springer, Boston, MA. https://doi.org/10.1007/978-1-4684-5829-9_24

Download citation

  • DOI: https://doi.org/10.1007/978-1-4684-5829-9_24

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4684-5831-2

  • Online ISBN: 978-1-4684-5829-9

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation