Interventions in lifestyle, diet, exercise, drugs, stents or surgery.
Dear Leonardo, In my opinion the ideal is prevention. Thus, physical exercise along with a balanced diet would be the perfect combination. However, depends on the patient's history and level atherosclerotic plaque.
Statins decrease atherosclerosis by lowering low-density-lipoprotein cholesterol. Statins are also thought to have additional anti-atherogenic properties, yet defining these non-conventional modes of statin action remains unclear. Statins may exhibit some of their clinical benefits by not only retarding the progression of atherosclerosis, but also accelerating its regression
Basic Pathophysiology is as follow: Atherosclerotic plaque regression encompasses a variety of processes that can be grouped into three main areas: removal of lipids and necrotic material; restoration of endothelial function and repair of denuded areas; and cessation of vascular smooth muscle cell proliferation and phenotype reversal. In addition to the role of high-density lipoproteins in lipid removal, resident macrophages and foam cells are able to regain motility and rapidly migrate on milieu improvement, moving both lipids and necrotic material to regional lymph nodes. Neighbouring endothelial cells can proliferate and replace dead and dysfunctional cells. Circulating endothelial progenitor cells can similarly restore vessel function.
Plaque regression is not simply a rewinding of the sequences of events that lead to lesion progression, but instead involves specific cellular and molecular pathways that are eventually able to mobilize all pathological components of the plaque. HDL, endothelial Cells and vascular smooth muscles cells all play important roles in the progression and regression of atherosclerosis. Targeting of these cells and molecules in the future will ensure pharmaceutical agents are able to elicit even better plaque regression.
Dear Leonardo
This article may be useful for you
G Ital Cardiol (Rome). 2009 Dec;10(11-12 Suppl 3):13S-17S.
[Atherosclerosis regression and plaque stabilization: comparison of therapeutic targets].
D'Addato S1, Borghi C
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