Pharmacological Approach to the Prevention of Atherosclerosis

  • G. Crepaldi
  • G. Baggio
  • E. Manzato
Conference paper


The prevention of Atherosclerosis (ATS) is generally divided into primary and secondary. Primary prevention is the set of interventions carried out on the asymptomatic patient before the appearance of atherosclerotic complications (angina, myocardial infarction, stroke, etc.), whereas by secondary prevention it is usually indicated any intervention after a clinical event has already occurred(1). Thus, pharmacological studies for the prevention of ATS should be divided into primary and secondary, even though this division is not always present in all the epidemiological trials.


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  1. 1.
    Levy RI (1980) Dietary prevention of coronary artery disease-A policy overview. In: Gotto AM Jr, Smith LC, Allen B(eds) Atherosclerosis V, Springer-Verlag, New York Heidelberg Berlin, pp199–208CrossRefGoogle Scholar
  2. 2.
    Krasno LR, Kidera GJ (1972) Clofibrate in coronary heart disease. Effect on morbidity and mortality. JAMA 219: 845–851PubMedCrossRefGoogle Scholar
  3. 3.
    Committee of Principal Investigators (1978) A co-operative trial in the primary prevention of ischaemic heart disease using clofibrate. Br Heart J 40: 1069–1118Google Scholar
  4. 4.
    Dörr AE, Gundersen K, Schneider JC Jr, Spencer TW, Martin WB (1978) Colestipol hydrochloride in hypercholesterolemic patients. Effect on serum cholesterol and mortality. J Chron Dis 31: 5–14PubMedCrossRefGoogle Scholar
  5. 5.
    Lipid Research Clinics Program (1979) The coronary primary prevention trial: design and implementation. J Chron Dis 32: 609–631Google Scholar
  6. 6.
    Hamilton M, Thompson EN, Wisniewski TKM (1964) The role of bloodpressure control in preventing complications of hypertension. Lancet i: 235–238CrossRefGoogle Scholar
  7. 7.
    Veterans Administration Cooperative Study Group on Antihypertensive Agents (1970) Effect of treatment on morbidity in hypertension. II. Results in patients with diastolic blood pressure averaging 90 through 114 mmHg. JAMA 213: 1143–1152Google Scholar
  8. 8.
    Beevers DG, Fairman MJ, Hamilton M, Harpur JE (1973) The influence of antihypertensive treatment over the incidence of cerebral vascular disease. Postgrad Med J 49: 905–907PubMedCrossRefGoogle Scholar
  9. 9.
    Smith WMCF (1977) Treatment of mild hypertension. Results of a ten-year intervention trial. U.S. Public Health Service Hospitals Cooperative Study Group. Circ. Res. 40(1): 98–105Google Scholar
  10. 10.
    Beevers DG, Johnston J, Devine BL, Dunn FG, Larkin H, Titterihgton DM (1978) Relation between prognosis and the blood pressure before and during treatment of hypertensive patients. Clin Sci Mol Med 55: 333s–336sGoogle Scholar
  11. 11.
    Berglund G, Wilhelmsen L, Sannerstedt R, Hansson L, Andersson O, Sivertsson R, Wedel H, Wikstrand J (1978) Coronary heart disease after treatment of hypertension. Lancet i: 1–5CrossRefGoogle Scholar
  12. 12.
    Hypertension Detection and Follow-up Program Cooperative Group (1979) Five-year findings of the hypertension detection and follow-up program. I.Reduction in mortality of persons with high blood pressure, including mild hypertension. JAMA 242: 2562–2571Google Scholar
  13. 13.
    Hypertension Detection and Follow-up Program Cooperative Group (1979) Five-year findings of the hypertension detection and follow-up program. II.Mortality by race, sex and age. JAMA 242: 2572–2577Google Scholar
  14. 14.
    Management Committee (1980) The Australian therapeutic trial in mild hypertension. Lancet i: 1261–1267Google Scholar
  15. 15.
    Helgeland A (1980) Treatment of mild hypertension: a five year controlled drug trial. The Oslo Study. Am J Med 691 725–732CrossRefGoogle Scholar
  16. 16.
    Trafford JAP, Horn CR, O’Neal H, McGonigle R, Halford-Maw L, Evans R (1981) Five year follow-up of effects of treatment of mild and moderate hypertension. Br Med J 282: 1111–1113CrossRefGoogle Scholar
  17. 17.
    Gruppo di Ricerca del Progetto Romano di Prevenzione della Cardiopatia Coronarica (1981) La prevenzione di alcune complicanze cardiovascolari mediante trattamento multifattoriale degli ipertesi. G Ital Cardiol 11: 164–169Google Scholar
  18. 18.
    Veterans Administration Cooperative Study Group on Antihypertensive Agents (1967) Effects of treatment on morbidity in hypertension. Results in patients with diastolic blood pressures averaging 115 through 129 mmHg. JAMA 202: 1028–1034Google Scholar
  19. 19.
    Johnsson S (1960) Retinopathy and nephropathy in diabetes mellitus (comparison of the effects of two forms of treatment) Diabetes 9: 1–8PubMedGoogle Scholar
  20. 20.
    Jarrett RJ, Mc Cartney P, Keen H (1982) The Bedford survey: ten year mortality rates in newly diagnosed diabetics, borderline diabetics and normoglycaemic controls and risk indices for coronary heart disease in borderline diabetics. Diabetologia 22: 79–84PubMedGoogle Scholar
  21. 21.
    University Group Diabetes Program (1970) A study of the effects of hypoglycemic agents of the vascular complications of patients with adult-onset diabetes. Diabetes 19(2): 747–830Google Scholar
  22. 22.
    Paasikivi J, Wahlberg F (1971) Preventive tolbutamide treatment and arterial disease in mild hyperglycaemia. Diabetologia 7: 323–327PubMedCrossRefGoogle Scholar
  23. 23.
    Paasikivi J (1971) Long-term tolbutamide of survivors from myocardial infarction. Acta diabet lat 8(1): 437–443CrossRefGoogle Scholar
  24. 24.
    Coronary Drug Project Research Group (1373) Findings leading to discontinuation of the 2.5 mg/day estrogen group. JAMA 226:652–657Google Scholar
  25. 25.
    Coronary Drug Project Research Group (1970) Initial findings leading to modifications of its research protocol. JAMA 214: 1303–1313Google Scholar
  26. 26.
    Coronary Drug Project Research Group (1972) Findings leading to further modifications of its protocol with respect to dextrothyroxine. JAMA 220: 996–1008Google Scholar
  27. 27.
    Coronary Drug Project Research Group (1975) Clofibrate and niacin in coronary heart disease. JAMA 231: 360–381Google Scholar
  28. 28.
    Newcastle upon Tyne Region Group of Physicians (1971) Trial of clofibrate in the treatment of ischaemic heart disease. Br Med J 4: 767–775Google Scholar
  29. 29.
    Scottish Society of Physicians Research Committee (1971) Ischaemic heart disease: a secondary prevention trial using clofibrate. Br Med J 4: 775–784Google Scholar
  30. 30.
    Rosenhamer G, Carlson LA (1980) Effect of combined clofibrate-nicotinic acid treatment in ischemic heart disease. Atherosclerosis 37: 129–138PubMedCrossRefGoogle Scholar
  31. 31.
    Oliver MF (1981) Coronary heart disease prevention. Trials using drugs to control hyperlipidaemia. In: Miller NE, Lewis B (eds I Lipoprotein, atherosclerosis and coronary heart disease, Elsevier Amsterdam, pp165–195Google Scholar
  32. 32.
    Wilhelmsson C, Vedin JA, Wilhelmsen L, Tibblin G, Werkö L (1974) Reduction of sudden deaths after myocardial infarction by treatment with alprenolol. Lancet ii: 1157–1160CrossRefGoogle Scholar
  33. 33.
    Multicentre International Study (1977) Reduction in mortality after myocardial infarction with long-term beta-adrenoceptor blockade. Br Med J 2: 419–421Google Scholar
  34. 34.
    Baber NS, Wainwright Evans D,, Howitt G, Thomas M, Wilson C, Lewis JA, Dawes PM, Handler K, Tuson R (1980). Multicentre post-infarction trial of propranolol in 49 hospitals in the United Kingdom, Italy, and Yugoslavia. Br Heart J 44: 96–100PubMedCrossRefGoogle Scholar
  35. 35.
    Norwegian Multicenter Study Group (1981) Timolol-induced reduction in mortality and reinfarction in patients surviving acute myocardial infarction. N Engl J Med 304: 801–807Google Scholar
  36. 36.
    Beta-blocker Heart Attack Trial Research Group (1982) A randomized trial of propranolol in patients with acute myocardial infarction. JAMA 247: 1707–1714Google Scholar
  37. 37.
    Hansteen V, Møinichen E, Lorentsen E, Andersen A, Strøm 0, Søiland K, Dyrbekk D, Refsum AM, Tromsdal A, Knudsen K, Eika C, Bakken J jun, Smith P, Hoff PI (1982) One year’s treatment with propranolol after myocardial infarction: preliminary report of Norwegian Multicentre trial. Br Med J 284: 155–160CrossRefGoogle Scholar
  38. 38.
    Elwood PC, Cochrane AL, Burr ML, Sweetnam PM, Williams G, Welsby E, Hughes SJ, Renton R (1974) A randomized controlled trial of acetyl salicylic acid in the secondary prevention of mortality from myocardial infarction. Br Med J 1: 436–440PubMedCrossRefGoogle Scholar
  39. 39.
    Coronary Drug Project Research Group (1976) Aspirin in coronary heart disease. J Chron Dis 29: 625–642Google Scholar
  40. 40.
    Elwood PC, Sweetnam PM (1979) Aspirin and secondary mortality after myocardial infarction. Lancet ii: 1313–1315CrossRefGoogle Scholar
  41. 41.
    Aspirin Myocardial Infarction Study Research Group (1980) A randomized, controlled trial of aspirin in persons recovered from myocardial infarction. JAMA 243: 661–669Google Scholar
  42. 42.
    Breddin K, Loew D, Lechner K, Oberla K, Walter E (1980) Secondary prevention of myocardial infarction. A comparison of acetylsalicylic acid, placebo and phenprocoumon. Haemostasis 9: 325–344PubMedGoogle Scholar
  43. 43.
    Persantine-Aspirin Reinfarction Study Research Group (1980) Persantine and aspirin in coronary heart disease. Circulation 62: 449–461Google Scholar
  44. 44.
    Anturane Reinfarction Trial Research Group (1980) Sulfinpyrazone in the prevention of sudden death after myocardial infarction. N Engl J Med 31: 250–256Google Scholar
  45. 45.
    Anturan Reinfarction Italian Study (1982) Sulphinpyrazone in post-myocardial infarction. Lancet i: 237–242Google Scholar
  46. 46.
    Fields WS, Lemak NA, Frankowski RF, Hardy RJ (1977) Controlled trial of aspirin in cerebral ischemia. Stroke 8: 301–316PubMedCrossRefGoogle Scholar
  47. 47.
    Fields WS, Lemak NA, Frankowski RF, Hardy RJ (1978) Controlled trial of aspirin in cerebral ischemia. Part II. Surgical group. Stroke 9: 309–319PubMedCrossRefGoogle Scholar
  48. 48.
    Canadian Cooperative Study Group (1978) A randomized trial of aspirin and sulfinpyrazone in threatened stroke. N Engl J Med 299: 53–59Google Scholar
  49. 49.
    Stary HC (1979) Regression of atherosclerosis in primates.Virchows Arch (Pathol Anat) 383: 117–134CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1983

Authors and Affiliations

  • G. Crepaldi
  • G. Baggio
  • E. Manzato

There are no affiliations available

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