Platelets and ischemia play an important role in the progression of atherosclerosis. In order to clarify the pathogenetic mechanism triggered by ischemia in atherosclerotic disease, the relationship between ischemia and platelet function was studied in 25 patients with atherosclerotic disease (A group) and in 25 healthy subjects (H group).Early in the morning, at a fasting state, blood was drawn from an antecubital vein. The upper arm was compressed at a pressure of 20mmHg above systolic arterial pressure. Five minutes after compression, and immediately after releasing it, blood was obtained again. In each blood sample, we measured platelet counts, platelet aggregability, cytoplasmic free calcium ion concentration ([Ca++]i) in platelets, calmodulin concentration in platelets, plasma β-thromboglobulin (β-TG), plasma platelet factor 4 (PF4), plasma c-AMP, plasma 6-keto PGF1α, plasma thromboxane B2, pH, P02, PCO2 and serum lactic acid concentration.Platelet counts decreased significantly 5 minutes after compression. Platelet aggregability in the H group was suppressed during and after compression. In the A group, however, aggregability increased slightly or showed no change.A significant increase in [Ca++]i was noted in both groups 5 minutes after compression. The calmodulin concentration in group A was markedly lower than in group H. Calmodulin levels in group A increased significantly during and after compression, but decreased significantly in group H. Plasma β-TG and PF4 levels increased significantly during and after compression in both groups. The plasma c-AMP level increased significantly during and after compression in group A, while it tended to increase in group H during compression.Plasma 6-keto PGF1α concentrations showed no changes caused by ischemia in either group. A significant increase was noted during and after compression in both groups. PH and P02 concentrations decreased after 5 minutes of ischemia in both groups. PCO2 and lactic acid concentrations increased after 5 minutes of ischemia in both groups. The magnitude of pH, P02, PCO2 and lactate changes was greater in group A than in group H.The consumption of easy aggregative platelets may induce decreased platelet counts after 5 minutes of ischemia. Ischemia brought about a significant increase of [Ca++]i and activated platelets. On the other hand, the suppression of platelet aggregability in group H was related to the decreased calmodulin in the platelets. Platelet aggregability was not suppressed during ischemia in group A because calmodulin levels in the platelets increased. The platelets were activated by ischemia and released β-TG, PF4 and thromboxane A2. C-AMP decreases [Ca++]i and suppresses platelet function. C-AMP was increased by ischemia in group A to maintain homeostasis in vivo. The changes of pH, P02, PCO2 and lactate reflected a certain ischemia in our methods.In conclusion, vascular accidents frequently occur in atherosclerotic patients. Therefore, controlling calmodulin levels might be important in reducing vascular accidents following ischemia.