Ageing and atherosclerosis

Yamada, Y. et al. Correlations between plasma platelet-activating factor acetylhydrolase (PAF-AH) activity and PAF-AH genotype, age, and atherosclerosis in a Japanese population. Atherosclerosis 150 (2000) 209-16. 

Kaunitz, H. Medium chain triglycerides (MCT) in aging and atherosclerosis. J. Environ. Pathol. Toxicol. Oncol. 6, 115-121, 1986. 

Reduction in semm Hpids can contribute significantly to prevention of atherosclerosis. In 1985 a consensus report indicating that for every 1% reduction in semm cholesterol there is a 2% reduction in adverse effects of coronary heart disease was issued (145). Recommended semm cholesterol concentration was 200 mg/dL for individuals under 30 years of age, and individuals having concentration 240 mg/dL and LDL-cholesterol over 160 mg/dL should undertake dietary modification and possibly pharmacotherapy (146). Whereas the initial step in reducing semm cholesterol is through reduction of dietary cholesterol intake, a number of dmgs are available that can affect semm Hpid profile (see Fat substitutes). The pathway to cholesterol synthesis is shown in Figure 2. 

Cyanidin is the most common anthocyanin in foods. In addition, anthocyanins are stabilized by the formation of complexes with other flavonoids (co-pigmentation). In the United States, the daily anthocyanin consumption is estimated at about 200 mg. Several promising studies have reported that consumption of anthocyanin-rich foods is associated with reductions of the risks of cancers - and atherosclerosis and with preventive effects against age-related neuronal and behavioral declines. These beneficial effects of anthocyanins might be related to their reported biological actions such as modulators of immune response and as antioxidants. Knowledge of anthocyanin bioavailability and metabolism is thus essential to better understand their positive health effects. 

Concentrations of lipoprotein(a) were measured in 51 patients taking long-term carbamazepine, phenobarbital, phenytoin, or valproate and 51 age- and sex-matched controls (133). Lipoprotein(a) concentrations were above 450 pg/ml in 11 patients compared with only 4 controls, and the mean serum lipoprotein(a) concentrations were 330 and 169 pg/ml respectively. The epileptic patients also had a thicker intima media of the common carotid artery. These results suggest that patients taking antiepileptic drugs may be at a higher risk of atherosclerosis. 

Cardiovascular diseases, such as hypertension, coronary heart disease (CHD), and atherosclerosis, are associated with increased oxidative stress and are more common in men than in premenopausal women of similar age, with the incidence of CHD increasing significantly after menopause, with loss of cardiovascular protection attributed to estrogen deficiency [Forte et al., 1998]. Differences in the regulation of blood pressure and vascular function between males and females have been investigated extensively over the past... 

However, apart from disease states, there is a natural evolution of cytokine production with aging, including decreased T cell proinflammatory IL-2 and interferon-7 (type II pro-inflammatory IFN-7), decreased non-T cell antiinflammatory type I IFN (IFN-a and IFN-/3), and increased non-T cell proinflammatory IL-1, IL-6, and tumor necrosis factor a (TNF-o) [90], The IL-6 is one of the pathogenic elements of inflammatory and age-related diseases (AD and atherosclerosis) and has been defined as the cytokine for gerontologists [91]. 

Bruunsgaard H, Skinh0J P, Pedersen AN, Schroll M, Pedersen BK. Ageing, tumor necrosis factor-alpha (TNF-a) and atherosclerosis. Clin Exp Immunol. 2000, 121 255-260. 

Keso T, Perola M, Laippala P et al. Polymorphisms within the tumor necrosis factor locus and prevalence of coronary artery disease in middle-aged men. Atherosclerosis. 2001, 154 691-697. 

Rauscher FM, Goldschmidt-Clermont PJ, Davis BH, et al. Aging, progenitor cell exhaustion, and atherosclerosis. Circulation 2003 108 457-463. 

Q8 Risk factors for stroke include hypertension, hyperlipidaemia, hypercoagulability of blood, sluggish blood flow (e.g. following surgery or myocardial infarction) and atherosclerosis. All these predispose patients to stroke. Age could also be included here as the incidence of thromboembolism increases in those over 50 years of age. 

CAD-related deaths occurring before 65 years of age. There are approximately 78 million 20- to 39-year-olds in the U.S. today compared with 72 million in 1980.2 More than 25% or 19.5 million have plasma LDL-C greater than 144 mg/dl, making this population a vast reservoir of futnre patients to bnrden healthcare facilities and resources as they age into their 50s and 60s. Effective prevention strategies focnsed on the yonng adult age group could potentially decrease the incidence of advanced atherosclerosis or considerably delay its onset, improve qnality of life at older ages, and ease the financial bnrden associated with atherosclerotic diseases, which is approximately 146.2 billion a year for coronary heart disease and stroke combined. ... 

It is not known whether these changes are the result of a normal aging process (i.e., involutional) or the result of the interplay of pathology and age. Cumulative exposure to common causes of chronic kidney disease (CKD), such as (1) atherosclerosis, (2) hypertension, (3) heart failure, (4) diabetes,(5) obstructive nephropathy, (5) infection, (6) immune insult, (7) nephrotoxins such as lead, and (8) dietary protein increases with age and it is difficult to separate these effects from those of healthy aging. The decline in GFR with increasing age may be largely attributable to hypertension, atherosclerosis, or heart failure. In the absence of these or other identifiable causes of kidney disease, many older subjects have stable GFR over time. 

---