Risk factors and processes involved in atheroslerosis - this includes the detailed effect of smoking within the endothelial wall as well as the effect this has on vascular remodelling
• atherosclerosis causes lesions/abnormalities to vessels
• The initial (type I) lesion contains enough atherogenic lipoprotein to elicit an
increase in macrophages and formation of scattered macrophage foam cells. As in
subsequent lesion types, the changes are more marked in locations of arteries with
adaptive intimal thickening. (Adaptive thickenings, which are present at constant
locations in everyone from birth, do not obstruct the lumen and represent
adaptations to local mechanical forces).
• Type II lesions consist primarily of layers of macrophage foam cells and lipid-laden
smooth muscle cells and include lesions grossly designated as fatty streaks.
SMOKING
• Several studies in the past 40 years have analyzed the effect of smoking on serum
lipids. However, the first clear results stem from 1989; Craig et al14 showed a
statistically significant correlation between smoking and increased total serum
cholesterol, very–low-density lipoprotein, low-density lipoprotein (LDL), and
triglyceride serum concentrations.
• LDLs have a proatherogenic role in vascular damage
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