Pathophysiology of Atherosclerosis

Vascular diseases caused by atherosclerosis remain among the leading causes of mortality and morbidity worldwide and are responsible for enormous health economic burden. Atherosclerosis is a chronic inflammatory disease of blood vessels that can be initiated as early as childhood and develops over decades. It is marked by the formation of lipid-rich plaques that pose risk by their flow-limiting nature and propensity for rupture or erosion and thrombotic occlusion. Its pathophysiology involves numerous different molecular and cellular mediators, including a diverse array of vascular, innate and adaptive immune cell subtypes. This chapter discusses the complex pathogenesis of atherosclerosis and its evolution from early stage fatty streaks to the development of advanced thin cap fibroatheromas that are vulnerable to thrombotic complications.