The Pathogenesis of Vascular Disease

Abstract

The prevalence of vascular disease has increased in both the United States and Europe since the end of World War II. The pathogenesis of vascular disease has been directly linked to changes in dietary habits and lifestyle practices and the discovery of penicillin by Sir Alexander Fleming in 1928, which led to a reduction in deaths secondary to bacterial infections. Multiple theories have evolved regarding the various factors associated with an increased risk of vascular disease. It is important to realize, however, that the study of the pathogenesis and subsequent treatment of vascular disease requires a “bigger picture” approach rather than consideration of just one or two factors. In this chapter, we review the contributions made by many investigators who have looked at one or more of these issues. We discuss the relationship (Fleming’s Unified Theory of Vascular Disease1) between these factors (Figure 64.1) and their overall role in the pathogenesis of vascular disease, including coronary artery disease, carotid artery disease, and peripheral vascular disease. We also review the importance and benefit of looking at each of these contributing factors when evaluating and treating an individual with vascular disease.