Biochemical markers and physiological tests of atherosclerosis--changes and usefulness of markers in anti-atherosclerotic therapy

As a result of the aging of the Japanese population and westernization of the diet, atherosclerotic diseases such as ischemic heart diseases and cerebrovascular disorders are now the leading causes (2nd and 3rd, respectively) of death in Japan. Furthermore, advances in medical technology have made Japanese some of the longest-lived citizens in the world, and increasing health care costs have become an object of public concern. Therefore, the prevention and treatment of atherosclerosis that causes these ischemic organ dysfunctions is indispensable. In Japan, diagnostic criteria were established for metabolic syndrome as one of the health care cost-containment policies, and the importance of controlling the blood lipid and glucose levels and blood pressure was defined in 2005. Furthermore, persons enrolled in the health insurance system aged between 40 and 74 years have been obliged to receive a specified health check for the prevention of metabolic syndrome since April 2008. The health check includes: a medical interview; anthropometry (height, body weight, BMI, and abdominal circumference); physical examination; blood pressure; and 8 laboratory tests (neutral fat, HDL-cholesterol, LDL-cholesterol, AST, ALT, gamma-GT, fasting blood glucose [or HbAlc], and urinary protein and glucose). In fact, the specified health check is becoming one of the enlightening activities concerning the maintenance and promotion of health for staff of Kitasato University Hospital. Recently, on the other hand, the mechanism in which inflammatory reactions are involved in atherosclerosis has been elucidated, and atherosclerosis is thought to be a chronic inflammatory disease. Furthermore, the advances in laboratory test methods have made the measurement of various sensitive markers for inflammation possible. In this presentation, we would like to explain the efficient application of biochemical markers and rapid physiological tests for the pathological diagnosis of atherosclerosis. We would also like to explain changes in anti-thrombotic therapy aiming at the primary prevention of atherosclerosis and its usefulness.