PATHOGENESIS OF ATHEROSCLEROSIS

Cardiovascular disease is the leading cause of death in the United Sta tes. According to numbers complied by the American Heart Association, nearly one of every two Americans dies of cardiovascular disease, For example, in 1987, 976,706 (46%) of the estimated 2,127,000 deaths reco rded in the United States were attributable to diseases of the heart a nd blood vessels [1]. Most of these deaths can be attributed to athero sclerosis and its ensuing complications, The pathogenesis of atheroscl erosis is not completely understood. Nevertheless, the purpose of this review is to provide an overview of how an atherosclerotic lesion mig ht develop on the basis of our current understanding. This overview wi ll focus on one hypothesis of atherosclerosis development, the modifie d response-to-injury hypothesis. Several additional hypotheses will be described briefly. These descriptions can serve as a framework on whi ch researchers can build a more complete understanding of the processe s involved in this complicated, multifactorial disease.