An increase in cholesterol levels lead to atherosclerosis and stroke
Arteriosclerosis, also known as atherosclerosis, is a well-known medical term and a significant factor in various diseases such as stroke, coronary artery disease, and myocardial infarction. The exact causes of arteriosclerosis are not fully understood. Modern medical analysis and research suggest that it is primarily caused by dysregulation of lipid metabolism and the disruption of normal vascular wall function and structure.
Scientific studies have shown that patients often have systemic dyslipidemia before the formation of arteriosclerosis, with excessive lipid storage in the body leading to elevated lipid levels in the plasma, commonly known as hyperlipidemia. The infiltration of excessive lipids from the plasma into the arterial intima can cause the formation of atherosclerosis plaques. Dissection of hardened large arteries has revealed that the lipid composition within the intima and atherosclerotic plaques is similar to the classification of plasma lipids, confirming that lipid infiltration into arterial walls is one of the causes of arteriosclerosis.
It is normal for human serum to contain a certain proportion of cholesterol. There is also a component called phospholipids in the serum, which helps maintain cholesterol in a dissolved state. When cholesterol increases and phospholipids decrease, cholesterol can precipitate and adhere to the inner walls of arteries, leading to thickening and increased fragility of the arterial wall, resulting in arteriosclerosis. When blood pressure suddenly rises, these hardened arteries are more prone to rupture and bleeding. Conversely, low blood pressure and slow blood flow can lead to the formation of blood clots, which can also cause stroke. Therefore, actively preventing and treating hypercholesterolemia is an important aspect of stroke prevention.
The human body is constantly undergoing metabolic processes, and the arteries are no exception. Under normal circumstances, the metabolism of arterial walls relies on the plasma components flowing within the blood vessels. These components permeate through the vessel walls and flow towards the lymphatic vessels outside the blood vessels. In this process, the arterial walls receive nutrients and oxygen supply and remove metabolized waste products.
If there is an excessive amount of lipids in the bloodstream, the lipids (mainly lipoproteins) that enter the vessel walls can become trapped and deposited, leading to the disruption of the normal function and structure of the arterial wall. This situation often forms a vicious cycle, where the damaged arterial wall further allows lipids in the blood to infiltrate and deposit within the arterial wall, which cannot be cleared, ultimately developing into atherosclerotic plaques.
European study on atherosclerosis and stroke
A notable European study on atherosclerosis and stroke is the EUROASPIRE (European Action on Secondary Prevention by Intervention to Reduce Events) series, which is conducted by the European Society of Cardiology (ESC) in collaboration with other European societies. The primary research institution behind this study is the ESC, which coordinates the efforts of various European healthcare providers and research centers.
Research Content:
The EUROASPIRE studies are designed to assess the long-term outcomes and quality of life of patients who have experienced cardiovascular events such as heart attacks or strokes, with a specific focus on secondary prevention strategies. The research examines the implementation of guidelines-based care in clinical practice, including lifestyle modifications, pharmacological treatments, and risk factor management in patients with atherosclerosis, a major underlying cause of stroke.
Research Findings:
The EUROASPIRE surveys have consistently highlighted several key findings:
- Lifestyle Factors: There is a persistent gap between recommended and actual lifestyle changes among patients, with many not achieving recommended levels of physical activity, dietary improvements, and smoking cessation.
- Pharmacological Interventions: Despite evidence-based recommendations, not all patients receive appropriate drug therapies to manage risk factors such as high blood pressure, high cholesterol, and diabetes.
- Risk Factor Control: Many patients do not have their risk factors adequately controlled, which increases the risk of recurrent cardiovascular events, including stroke.
- Healthcare Delivery: The studies have pointed out the need for better integration of healthcare services to ensure that patients receive continuous and coordinated care, which is crucial for secondary prevention.
Research Impact:
The EUROASPIRE studies have had a significant impact on healthcare policy and practice in Europe. They have prompted discussions and actions to improve the management of cardiovascular disease, particularly in the realm of secondary prevention. The findings have been used to advocate for better patient education, more effective healthcare provider training, and systemic changes in healthcare delivery to enhance patient outcomes and reduce the burden of atherosclerosis-related strokes.
In summary, the EUROASPIRE series, led by the European Society of Cardiology, provides critical insights into the management of patients with atherosclerosis and the prevention of stroke through secondary interventions. The research underscores the importance of adherence to guideline-based care and highlights areas where improvements in clinical practice and healthcare systems are needed.
