The Precursors of Atherosclerosis, Cardiovascular Disease

By James M. Rippe

Biological factors that contribute to the development of cardiovascular disease are present from birth and perform vital functions that enable the human body to grow and resist infection. As a consequence, all human beings are born with the potential to develop heart disease. The early precursors of atherosclerosis frequently occur in children, teens, and young adults.

Fortunately, adopting a heart-healthy lifestyle can usually reverse these early manifestations. The sooner you start, the better, but it’s never too late.

Current biomedical evidence has led to a consensus that atherosclerosis is a multifactorial chronic inflammatory disease that starts with the dysfunction of and/or injury to the endothelium, which is the inner lining of artery walls.

Although only a single-cell-deep layer, the endothelium regulates the normal functioning of the arterial vessel walls. It acts as the traffic cop responding to the many blood-borne influences and biochemical signals that can modify the arterial walls. When any factor stresses or injures the endothelium, it triggers the inflammatory response that activates a variety of immune system signals and cells that rush to repair the damage.

If this process is triggered just occasionally, then this immune response repairs the damaged cells and shuts down until additional injury occurs. Unfortunately, the damage produced by most risk factors is constant and chronic. Risk factors such as elevated levels of LDL cholesterol and other lipids (fats), high blood pressure, smoking, and insulin resistance and diabetes cause chronic endothelial dysfunction and inflammation, and keep the immune response stuck in the “on” position.

Inflammation serves as a mediator in the disease progression by recruiting various immune system fighter and repair cells. The exact pathways by which inflammation exerts its influence are emerging from current research. Scientists are looking especially for inflammation markers that may help physicians diagnose and treat people at high risk of CHD in its early stages before symptoms arise, when lifestyle and medical therapies may halt or even reverse the disease.