Metabolic Abnormalities in Cerebral and Peripheral Arteriosclerosis
Numerous clinical and epidemiological studies have shown that various arterial districts (coronary arteries, cerebral arteries, and arteries of the lower limbs) may be simultaneously affected by sclerotic processes in the same patient, confirming that the pathogenetic mechanisms are similar regardless of site. The International Atherosclerosis Project , implemented in 19 different geographic areas throughout the world, found a very strong correlation between coronary and aortic lesions. In the Tecumseh study  coronary heart disease and absence of peripheral pulses were found to be associated. More recently, the Framingham study  showed that claudicatio intermittens was four times more frequent in patients of either sex affected by coronary heart disease (CHD) than in controls. Patients with peripheral artery disease (PAD) were likewise more frequently affected by CHD. Moreover, certain clinical manifestations of CHD, such as angina pectoris and myocardial infarction, seemed to increase the risk of stroke by a factor of 2–4. The Basel prospective study  confirmed this reciprocal association between coronary and extracoronary arteriosclerosis, showing that males with PAD presented CHD twice as frequently as controls, and that those with CHD were twice as likely as controls to present PAD. This study also confirmed the findings reported in the Framingham  and Seven County studies  that arterial hypertension, low-density lipoprotein cholesterol (LDL-C), cigarette smoking, and diabetes mellitus are all risk factors for both CHD and PAD. The most important metabolic risk factors recognized for PAD and cerebrovascular disease (CVD) are reduction of high-density lipoprotein cholesterol (HDL-C), hyperlipidemia, diabetes, and overweight.
KeywordsCoronary Heart Disease Peripheral Artery Disease Framingham Study Transient Ischemia Attack Arteriosclerosis Obliterans
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