New approaches to the concept of primary prevention of atherosclerosis.

Our understanding of the etiology of atherosclerosis and the mechanisms by which conventional cardiovascular risk factors cause disease is incomplete. Atherosclerosis may be regarded as a process of continuous injury and abnormal repair. The diagnosis and treatment of the disease should be targeted to the various stages of this process, from the early stages of vascular injury to the stabilization of the vulnerable plaque. Several novel concepts in atherosclerosis have been elucidated in the past two decades. Novel biomarkers and imaging techniques for early subclinical atherosclerotic lesions may facilitate earlier primary prevention. Future primary prevention of atherosclerosis should incorporate these novel concepts for creation of individualized risk profiles and therapies.