Atherosclerosis and aging: a scenario in flux.

Atherosclerosis is an age-related process that reflects the interaction between aging per se (primary aging) and factors that influence the rate of atherogenesis. Some of the latter are physiologic, notably sex steroid levels and possibly changes in adiposity, whereas others are modulated by diet and other aspects of lifestyle, such as cigarette smoking and hypertension. Recent declines in atherosclerotic disease suggest that the rate of atherogenesis is amenable to both changes in lifestyle and effective pharmacologic management of risk factors, deferring the onset of clinical disease until late in life or preventing its emergence altogether.