Coronary and cerebrovascular atherosclerosis: two aspects of the same disease or two different pathologies?

ABSTRACT

Cerebrovascular and coronary disease are characterized by some common aspects. Indeed the same risk factors relate to coronary heart disease and to cerebrovascular disease. However, there may be differences in the pathogenesis of atherosclerotic lesions in coronary and cerebral arteries. In fact some populations are characterized by a high incidence of ischaemic stroke and a low incidence of myocardial infarction, while in other populations there is an opposite trend. These differences could be explained on the basis of genetic risk factors; a different prevalence of risk factors; a different reactivity of the coronary and cerebral arteries to risk factors; anatomical differences concerning coronary and extracranial cerebral arteries with respect to intracranial cerebral arteries. Atherosclerosis is undoubtedly a systemic disorder and its genetic and environmental causal factors are only partly known. The variable incidence of cerebrovascular and coronary heart disease in the same population or in different populations as well as the different nature of atherosclerotic plaques are probably related to the different prevalence of the causal factors, even though these may not always be identified.