Regression of atherosclerosis. A role for calcium antagonists

M L Armstrong; D D Heistad; J A Lopez

doi:10.1093/ajh/4.7.503S

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Regression of atherosclerosis. A role for calcium antagonists

Journal article

Peer reviewed

Regression of atherosclerosis. A role for calcium antagonists

M L Armstrong, D D Heistad and J A Lopez

American journal of hypertension, Vol.4(7 Pt 2), pp.503S-511S

07/1991

DOI: 10.1093/ajh/4.7.503S

PMID: 1716917

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Abstract

The key processes responsible for plaque in atherosclerosis are cholesterol accumulation, caused by increased net uptake of atherogenic lipoproteins; cell proliferation and recruitment, caused by mitogenic and chemotactic activity; extracellular matrix expansion and collagen accumulation, caused by increased intimal cell synthesis; and high rates of cell death, caused by increased metabolic needs of tissue in an unfavorable milieu. Cell death is associated with neovascularization, dense fibrosis, and calcification, with the subsequent plaque complications of hemorrhage and thrombosis. An additional functional feature of atherosclerosis, even in prestenotic stages, is severe vasomotor abnormalities, caused in part by endothelial dysfunction. Reversal of atherosclerosis involves interrupting these processes. Calcium antagonists may block specific stages of atherogenesis. Anticalcifying agents (diphosphonates, thiophenes, and metallic ions) inhibit accumulation of connective tissue. Calcium channel blockers reduce endothelial injury and intimal permeability, block proliferation of intimal cells, inhibit lipid accumulation by a number of mechanisms, and reduce exaggerated vasoconstrictor responses. Thus, calcium antagonists may promote regression of lesions beyond what can be achieved by reducing risk factors alone.

Lipid Metabolism

Arteriosclerosis - drug therapy

Humans

Arteriosclerosis - physiopathology

Calcium Channel Blockers - therapeutic use

Neovascularization, Pathologic

Collagen - metabolism

Animals

Calcinosis - etiology

Vasomotor System - physiopathology

Cell Division

Cell Death

Fibrosis

Arteriosclerosis - metabolism

Arteriosclerosis - pathology

Details

Title: Subtitle: Regression of atherosclerosis. A role for calcium antagonists
Creators: M L Armstrong - Cardiovascular Center, University of Iowa College of Medicine, Iowa City 52242
D D Heistad
J A Lopez
Resource Type: Journal article
Publication Details: American journal of hypertension, Vol.4(7 Pt 2), pp.503S-511S
Publisher: United States
DOI: 10.1093/ajh/4.7.503S
PMID: 1716917
ISSN: 0895-7061
eISSN: 1879-1905
Grant note: HL-14230 / NHLBI NIH HHS
Language: English
Date published: 07/1991
Academic Unit: Cardiovascular Medicine; Neuroscience and Pharmacology; Internal Medicine
Record Identifier: 9984040599102771

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