Atherosclerosis – The Future Challenge for Europe’s Health Economies

Abstract

Atherosclerotic disease has been a feature of more affluent societies since ancient times. Currently, cardiovascular disease accounts for almost half of all mortality across Europe, causing over two million deaths within the EU and costing EU health economies €192 billion per year. The pathogenesis of atherosclerosis is complex, and our understanding of it has come a long way over the last 50 years. The public and many health professionals have an image of cholesterol that is probably over-simplistic. The oxidation of lowdensity lipoprotein (LDL) cholesterol to form oxLDL is the first molecular step in atherosclerosis pathogenesis, and it appears that oxLDL levels may act as a useful biomarker in identifying individuals at greatest risk of cardiovascular events. Inhibition of oxLDL or its active removal may represent a useful new therapeutic strategy. Antioxidants such as lycopene may offer another approach to prevention or treatment, and emerging evidence around the role of anti- Chlamydia pneumoniae antibodies in LDL oxidation could open up another avenue of preventative and therapeutic options.