Endothelial Dysfunction and Atherosclerosis: Role of Dietary Fats

Abstract

Atherosclerosis or arteriosclerosis is a generic term that defines a number of diseases in which the arterial wall becomes thickened and loses elasticity. Coronary heart disease (CHD), myocardial infarction, angina pectoris, cerebral vascular disease, and thrombotic stroke are few examples of such disorders. The development of atherosclerosis is a complex process that begins with an accumulation of lipid deposits on the arterial wall called “plaques”. The plaque formation in the inner lining of vessel wall progresses to arterial thickening and narrowing of its lumen, which can partially block the flow of blood through the artery. Extensive research is aimed to unravel the cellular and molecular events involved in the initiation and propagation of an atherogenic plaque. However, the exact sequence of events that leads to its development is still unknown. There is an increasing evidence that endothelial dysfunction is the primary event in the progression of atherosclerosis. Endothelial dysfunction is known to appear years before the actual symptoms of atherosclerosis develop, which emphasizes its causal role in the progression of the disease. Oxidative stress and inflammatory processes have been recognized as key mediators of the loss of normal endothelial function. In fact, reactive oxygen species (ROS) generation, and triggering of various inflammatory cascades are now known to be intimately linked with all the phases of development and progression of atherosclerosis. Consumption of high dietary fats can alter these parameters and therefore, play an important role in the etiology of CHDs. However, all fats do not exert similar effects in the development of these disorders. While saturated fat intake is associated with an increased incidence of CHDs, fish consumption has been shown to lower the incidence of these disorders. Considering the role played by different dietary fats in the alteration of lipoprotein metabolism and other inflammatory cascades, they are now looked upon as nutritional tool for the prevention of atherosclerosis and maintenance of normal cardiovascular health. This chapter provides a detailed account of endothelial dysfunction and its role in the development of atherosclerosis. The role of dietary fats in the development and progression of endothelial dysfunction and atherosclerosis has also been discussed.