The Hemodynamic Basis of Atherosclerosis

About the Lecture

Atherosclerosis, the buildup of plaque deposits on the interior of blood vessels, is found in varying degrees of severity in all individuals and cannot be cured in the sense of eliminating an infectious disease. It is the price we pay for blood flow as a requirement of life. Atherosclerosis develops primarily from the fluid effects of blood flow, or hemodynamics, through various blood vessel sections as curvatures, branches, bifurcations, tapers, and external attachments. As blood flows through narrow or curved sections, an area of low pressure develops against the vessel wall, stimulating the normal layer of endothelium to proliferate. This plaque gradually enlarges and further reduces the flow area. For example, the plaque builds up on the convex surface of a curvature, where the flow-induced area of low pressure occurs. Data from human autopsy specimens, hydraulic system models, and atherosclerosis lesion production experiments support the conclusion that atherosclerosis is a reactive biological response of blood vessels to hemodynamics. Current research aims to minimize or retard the rate of development by controlling the relevant blood flow parameters. A promising area of research is the decrease in blood velocity, which is expected to retard the progressive development of atherosclerosis if achieved without impairing the metabolic requirements of vital organs.