title: Epidemiology of Atherosclerosis and the Potential to Reduce the Global Burden of Atherothrombotic Disease.
abstract: Atherosclerosis is a leading cause of vascular disease worldwide. Its major clinical manifestations include ischemic heart disease, ischemic stroke, and peripheral arterial disease. In high-income countries, there have been dramatic declines in the incidence and mortality from ischemic heart disease and ischemic stroke since the middle of the 20th century. For example, in the United Kingdom, the probability of death from vascular disease in middle-aged men (35-69 years) has decreased from 22% in 1950 to 6% in 2010. Most low- and middle-income countries have also reported declines in mortality from stroke over the last few decades, but mortality trends from ischemic heart disease have been more varied, with some countries reporting declines and others reporting increases (particularly those in Eastern Europe and Asia). Many major modifiable risk factors for atherosclerosis have been identified, and the causal relevance of several risk factors is now well established (including, but not limited to, smoking, adiposity, blood pressure, blood cholesterol, and diabetes mellitus). Widespread changes in health behaviors and use of treatments for these risk factors are responsible for some of the dramatic declines in vascular mortality in high-income countries. In order that these declines continue and are mirrored in less wealthy nations, increased efforts are needed to tackle these major risk factors, particularly smoking and the emerging obesity epidemic.
authors.affiliation: From the Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, Oxford OX3 7LF, UK.
authors.forename: William
authors.initials: W
authors.lastname: Herrington
authors.affiliation: From the Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, Oxford OX3 7LF, UK.
authors.forename: Ben
authors.initials: B
authors.lastname: Lacey
authors.affiliation: From the Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, Oxford OX3 7LF, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Sherliker
authors.affiliation: From the Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, Oxford OX3 7LF, UK. jane.armitage@ctsu.ox.ac.uk.
authors.forename: Jane
authors.initials: J
authors.lastname: Armitage
authors.affiliation: From the Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, Oxford OX3 7LF, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Lewington
mesh_terms: D050197:Atherosclerosis / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control*; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D015897:Comorbidity; D014943:Global Health; D006801:Humans; D008019:Life Style; D011314:Preventive Health Services / Q000379:methods*; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D013997:Time Factors
chemical_list: D002317:Cardiovascular Agents
keywords: atherosclerosis; coronary; epidemiology; peripheral; stroke