[Atherosclerosis and the role of inflammation].

Inflammation plays an important role in the development of atherosclerotic vascular disease which is the leading cause of morbidity and mortality in the adult population. Various risk factors trigger an inflammatory response leading to the initiation and development of atherosclerotic vascular disease. Several adhesion molecules, cytokines, and growth factors secreted from the endothelium aggravate inflammation and increase subendothelial lipid accumulation. With continuing inflammation, plaque rupture occurs resulting in acute coronary syndromes. Recently, the importance of the immune system and the mechanisms of the inflammatory response have been elucidated. One of the markers of subclinical inflammation in atherosclerosis is increased levels of high-sensitivity CRP. Several clinical trials have shown that suppression of the inflammatory response can delay or decrease the atherosclerotic process. Among the approaches for a healthier lifestyle, diets low in saturated fats, the Mediterranean diet, and exercise have been shown to decrease the inflammatory response. Various pharmacologic agents also have anti-inflammatory effects. Lipid-lowering therapies, in particular statins have proved to have anti-inflammatory effects on atheromatous plaques. Several clinical trials have shown that patients with an increased inflammatory response benefit more from statins. Therapeutic approaches targeting directly the inflammatory response and vaccination against atherosclerosis are under investigation.