Metabolic Abnormalities in Cerebral and Peripheral Arteriosclerosis

  • R. Fellin
  • G. Valerio


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 [1], implemented in 19 different geographic areas throughout the world, found a very strong correlation between coronary and aortic lesions. In the Tecumseh study [2] coronary heart disease and absence of peripheral pulses were found to be associated. More recently, the Framingham study [3] 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 [4] 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 [5] and Seven County studies [6] 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.


Coronary Heart Disease Peripheral Artery Disease Framingham Study Transient Ischemia Attack Arteriosclerosis Obliterans 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    International Atherosclerosis Project (1968) The geographic pathology of atherosclerosis. Lab Invest 18: 5–180Google Scholar
  2. 2.
    Johnson BC, Epstein FH (1966) Absence of peripheral pulse in relation to other arterial disease in a community study. Am J Public Health 56: 1482–1492CrossRefGoogle Scholar
  3. 3.
    Kannel WB, Shurtleff D (1971) The natural history of arteriosclerosis obliterans. In: Brest, Gifford (eds) Peripheral vascular disease, vol 3. Davis, Philadelphia, pp 38–52Google Scholar
  4. 4.
    Widmer LK, Stahelin HB, Nissen C, Da Silva A (eds) (1981) Venen, Arterien, Krankheiten, Koronare Herzkrankheit bei Berufstätigen. Huber, BernGoogle Scholar
  5. 5.
    Kannel WB, McGee FD, Gordon T (1976) A general cardiovascular risk profile: the Fram-ingham study. Am J Cardiol 38: 46–51PubMedCrossRefGoogle Scholar
  6. 6.
    Menotti A, Giampaoli S (1986) Epidemiology and prediction of cerebral and peripheral vascular diseases. Monogr Atheroscler 14: 11–14PubMedGoogle Scholar
  7. 7.
    Gordon T, Kannel WB, Castelli WP, Dawber TR (1981) Lipoproteins, cardiovascular disease and death. The Framingham study. Arch Intern Med 141: 1128–1131PubMedCrossRefGoogle Scholar
  8. 8.
    Pilger E, Pristautz H, Pfeiffer KP, Kostner G (1983) Retrospective evaluation of risk factors for peripheral atherosclerosis by stepwise discriminant analysis. Arteriosclerosis 3: 57–63PubMedCrossRefGoogle Scholar
  9. 9.
    Kostner GM, Marth E, Pfeiffer KH, Wege H (1986) Laboratory parameters as discriminators for peripheral atherosclerosis and stroke. Monogr Atheroscler 14: 119–123PubMedGoogle Scholar
  10. 10.
    Franceschini G, Bondioli A, Matero M, Sirtori M, Tattoni G, Biasi G, Sirtori RC (1982) Increased apoprotein B in very low density lipoproteins of patients with peripheral vascular disease. Arteriosclerosis 2: 74–80PubMedCrossRefGoogle Scholar
  11. 11.
    Taggart H, Stout RW (1979) Reduced high density lipoprotein in stroke: relationship with elevated triglyceride and hypertension. Eur J Clin Invest 9: 219–221PubMedCrossRefGoogle Scholar
  12. 12.
    Rossner S, Kjellin KG, Mettinger KL, Siden A (1978) Normal serum cholesterol but low HDL-cholesterol in young patients with ischaemic cerebrovascular disease. Lancet I: 577–579Google Scholar
  13. 13.
    Sirtori CR, Gianfranceschi G, Gritti I, Nappi G, Brambilla G, Paoletti P (1979) Decreased high density lipoprotein cholesterol levels in male patients with transient ischaemic attacks. Atherosclerosis 32: 205–211PubMedCrossRefGoogle Scholar
  14. 14.
    Murai A, Tomoji T, Myahara T (1981) Lipoprotein abnormalities in the pathogenesis of cerebral infarction and transient ischaemic attack. Stroke 12: 167–172PubMedCrossRefGoogle Scholar
  15. 15.
    West KM, Ahuja MM, Bennet PH, Czyzyk A, Mateo de Acosta O, Fuller JH, Grab B, Grabauskas V, Jarrett J, Kosaka K, Keen H, Krolewski AS, Miki E, Schliack V, Teuscher A, Watkins PJ, Stober JA (1983) The role of circulating glucose and triglyceride concentrations and their interactions with other “risk factors” as determinants of arterial disease in nine diabetic population samples from the WHO multinational study. Diabetes Care 6: 361–369PubMedCrossRefGoogle Scholar
  16. 16.
    Kannel WB, McGee FD (1979) Diabetes and cardiovascular risk factors: The Framingham study. Circulation 59: 8–13PubMedGoogle Scholar
  17. 17.
    Chait A, Bierman EL, Brunzell JD (1985) Diabetic macroangiopathy. In: Alberti KG, Krall LP (eds) The diabetes annual, vol 1. Elsevier, Amsterdam, pp 323–348Google Scholar
  18. 18.
    Hubert HB, Feinleib M, McNamara PM, Castelli WP (1983) Obesity as an indipendent risk factor for cardiovascular disease: a 26year follow-up of participants in the Framingham Heart Study. Circulation 67: 968–977PubMedCrossRefGoogle Scholar
  19. 19.
    Anderson DW, Nichols AV, Brewer HB Jr (1979) Ultracentrifugal characterization of the human plasma high density lipoprotein distribution. In: Lippel K (ed) Report of the High Density Lipoprotein Methodology Workshop. NIH publication 79,1661, pp 290–300Google Scholar
  20. 20.
    Gidez LI, Miller GJ, Burstein M, Seagle S, Eder HA (1982) Separation and quantitation of subclasses of human plasma high density lipoproteins by a simple precipitation procedure. J Lipid Res 23: 1206–1223PubMedGoogle Scholar
  21. 21.
    Fellin R, Baroni L, Baiocchi MR, Baldo Enzi G, Grego F, Valerio G (1985) Selective determination of cholesterol in high density lipoprotein subfractions (HDL2 and HDL3) in patients with cerebral and peripheral arteriosclerosis. Clin Chim Acta 147: 233–240PubMedCrossRefGoogle Scholar
  22. 22.
    Bradby GVH, Valente AJ, Walton KW (1978) Serum high density lipoproteins in peripheral vascular disease. Lancet II: 1271–1274Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1987

Authors and Affiliations

  • R. Fellin
  • G. Valerio

There are no affiliations available

Personalised recommendations