Common features of atherosclerosis and venous disease

Jan Piťha
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Abstract

Atherosclerosis and venous diseases exert substantial burden on human population including high prevalence and incidence of mortality and disabling morbidity caused by these disorders. In contrast to the traditional belief, current evidence based on physiological and epidemiological findings indicates that atherosclerotic and venous disease share many common features. Pathophysiological mechanisms underlying both diseases is immune system represented by monocytes/macrophages which interact with endothelial layer of arteries and veins and cause atherosclerotic process and venous insufficiency. From epidemiological point of view, both diseases also share manageable risk factors including obesity, dyslipidemia, and hypertension. In addition, there is evidence for significant and causal association between atherosclerosis and venous thrombosis. Several management strategies including pharmacoherapy are proposed to be effective for prevention and treatment of atherosclerosis and venous disease. However, detailed knowledge of the pathophysiology connecting atherosclerosis and venous disease is still incomplete including data regarding “complex” treatment. The aim of this review is to present available evidence of pathophysiological and epidemiological aspects in common mechanisms of atherosclerotic and venous disease and to summarize clinical implications based on current knowledge.

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动脉粥样硬化和静脉疾病的共同特征
动脉粥样硬化和静脉疾病对人类造成了巨大的负担,包括由这些疾病引起的高患病率和高发死亡率和致残率。与传统观点相反,目前基于生理学和流行病学发现的证据表明,动脉粥样硬化和静脉疾病具有许多共同特征。这两种疾病的病理生理机制都是以单核/巨噬细胞为代表的免疫系统与动脉和静脉内皮层相互作用,导致动脉粥样硬化过程和静脉功能不全。从流行病学的角度来看,这两种疾病也有共同的可控风险因素,包括肥胖、血脂异常和高血压。此外,有证据表明动脉粥样硬化与静脉血栓形成之间存在显著的因果关系。包括药物治疗在内的几种治疗策略是预防和治疗动脉粥样硬化和静脉疾病的有效方法。然而,关于动脉粥样硬化和静脉疾病之间的病理生理学联系的详细知识仍然不完整,包括关于“复杂”治疗的数据。本综述的目的是在动脉粥样硬化和静脉疾病的常见机制中提供病理生理和流行病学方面的现有证据,并根据现有知识总结临床意义。
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