[The effect of reduced cholesterol on coronary arteries].
High levels of cholesterol increase the influx of calcium ions into vascular smooth muscle cells, thereby increasing vascular tone and resistance. Simultaneously, endothelium-dependent (NO-mediated) vasodilatation is inhibited in the arteries. Brief reductions in cholesterol induced by dietary intervention or with lipid lowering therapy normalize endothelial dysfunction, and myocardial perfusion will increase well before any beneficial effects on atherosclerosis are detected. These phenomena may explain, at least in part, that in spite of even small differences in angiographic findings between patients who have undergone treatment and those who have not, lowering lipids will cause major reductions in cardiovascular events. Lowering the levels of cholesterol will alter the content and composition of atherosclerotic plaques, thereby making them more stable. The result is probably a substantial reduction in the frequency of plaque rupture, and if rupture should occur, the thrombotic mechanisms will probably be weaker. Consequently, the risk of a thrombotic occlusion of a coronary vessel will be reduced.
Landmark
K
K
Institutt for farmakoterapi, Oslo.
Reikvam
A
A
D000924:Anticholesteremic Agents / Q000008:administration & dosage; D002784:Cholesterol / Q000097:blood*; D003324:Coronary Artery Disease / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D003331:Coronary Vessels / Q000473:pathology* / Q000503:physiopathology; D018752:Diet, Fat-Restricted; D004730:Endothelium, Vascular / Q000473:pathology; D006801:Humans
D000924:Anticholesteremic Agents; D002784:Cholesterol
Virkningen av kolesterolsenkning på koronararterier.