Fast Five Quiz: Noncoronary Atherosclerosis Signs and Symptoms

Yasmine S. Ali, MD

Disclosures

March 01, 2021

In the absence of overt atherosclerosis, endothelial dysfunction is a powerful early indicator of subclinical disease. Measurement of endothelial function has allowed for (1) a deeper understanding of the pathophysiology of early and late manifestations of atherosclerosis and its complications; (2) determining the importance of conventional and emerging risk factors of atherosclerosis; and (3) observing mechanisms of action in drug families (eg, angiotensin-converting enzyme inhibitors and statins) as well as lifestyle changes. Fortunately, the upper extremity arteries (ie, the brachial arteries) are relatively simple to assess noninvasively via ultrasound measurement of the brachial artery flow-mediated dilation.

As defined by the US National Cholesterol Education Program Adult Treatment Panel III guidelines, an HDL-C level ≥ 60 mg/dL is a negative (protective) risk factor. Conversely, a high-risk HDL-C level is described as being < 40 mg/dL.

Most people with familial hypercholesterolemia inherit one altered copy of the LDLR gene from an affected parent. These cases are associated with an increased risk for early heart disease, typically beginning in an individual's fourth or fifth decade of life.

Learn more about physical examination in atherosclerosis.

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