Cardiovascular Disease: A Historical Perspective.
Cardiovascular Disease: A Historical Perspective.
Year: 2000
Authors: D Smith.
Publication Name: Jpn. J. Vet. Res.
Publication Details: Volume 48; Numbers 2-3; Page 147.
Abstract:
Cardiovascular disease (CVD) is the leading cause of death and disability in the U.S. and most industrialized nations, and is the second leading cause of death worldwide. Currently, 29% of the deaths worldwide are attributed to CVD and this statistic is expected to increase to 36% by the year 2020. According to U.S. statistics, a direct cost of $259 billion was spent in the U.S. in 1996 alone on CVD related cases. In this review article the author attributes the major breakthroughs to modern day Cardiovascular and lipid research to the Framingham Heart Study, which is an ongoing prospective study to determine the risks associated with coronary artery disease (CAD), as well as the a study performed by Gofman and colleagues who correlated various lipoprotein classes (VLDL, LDL, HDL) to CAD. Subsequent studies have identified risk factors for the development of CAD to be hypercholesterolemia, hypertension, elevated TG levels, diabetes mellitus, obesity, as well as lifestyle factors such as cigarette smoking. Recently, elevated homocysteine levels were identified as a potential risk factor for the development of atherosclerosis and atherothrombosis. Smith reviews the role of diet in the development of atherosclerosis, where studies have clearly demonstrated diets rich in saturated fat (SFA) elevate plasma cholesterol and polyunsaturated fat results in decreased plasma cholesterol. Historically, monounsaturated fats (MUFAs) were believed to be neutral with respect to their effect on plasma cholesterol; however, recent studies have indicated that when MUFAs replace SFA in the diet, total LDL cholesterol was decreased with no effect on HDL or TG levels. In addition, studies have indicated that replacing dietary SFA with MUFA (from oils such as canola, olive, peanut, soybean, and cottonseed) may reduce CVD risk as a result of their antioxidant, antithrombotic, and antihypertensive properties. Thus, additional compounds found within vegetable oils such as tocopherols, tocotrienols, antioxidants, plant sterols, and other phytochemicals may instill added benefits in terms of CVD prevention. Diets rich in n-3 fatty acids, primarily the longer chain EPA and DHA, have proven beneficial in the secondary prevention of CHD. The positive effects of the longer chain n-3 PUFAs (EPA and DHA) are attributed to their anti-inflammatory, antithrombotic, antiarrhythmic, hypolipidemic, and vasodilatory properties. The author does note, however, that consumption of ALA (found in canola oil, flaxseed oil, green leafy vegetables, and walnuts) may be converted to EPA and DHA resulting in the above mentioned physiological benefits. Also provided in this review article is an overview for lipid metabolism, lipid transport, pathology, therapeutic intervention, and drug therapy in relation to CVD risk and treatment.
