Coronary, peripheral and cerebrovascular disease: a complex relationship.

Atherosclerosis is a diffuse process that may affect different vascular beds with considerable overlap between coronary, cerebrovascular and peripheral arterial disease. These conditions are related to similar predisposing risk factors and genetic predisposition. Presence of atherosclerosis at one arterial site should prompt the clinician to assess for an involvement, symptomatic or asymptomatic, at other arterial distributions. Patients with peripheral or cerebrovascular disease often receive less than optimal secondary preventive therapy than those with coronary artery disease. It is imperative that these individuals with noncoronary atherosclerotic disease be also treated aggressively to reduce the high adverse cardiovascular event rate reported in these patients.