Circulation: In The Netherlands, Researchers Observe Reduction in Unstable Plaques in Country's Population Over Several Years

Utrecht, April 3, 2014 - Based on a large-scale patient study, researchers of University Medical Center (UMC) Utrecht have discovered that a serious form of atherosclerosis has become less prevalent in the Netherlands. The findings of the study will soon be published in the prestigious medical journal Circulation.

As of 2002, UMC Utrecht and the Antonius Hospital in Nieuwegein have examined the arteries of over three thousand patients for the presence of dangerous accumulations of material that can cause acute cerebral infarctions.

During the UMC Utrecht study, the researchers found that over time patients had fewer of the unstable plaques and more of the stable ones. The changes they saw over the past ten years were so great that researchers started to doubt their findings. Prof. Gerard Pasterkamp, who led the research and heads the Department of Experimental Cardiology at UMC Utrecht: “At first we suspected that there was an error in our data, but that turned out not to be the case. All our tests showed that the results were correct after all This suggests that the incidence of the more dangerous type of atherosclerosis is receding in the Netherlands.”

It is still unclear what is driving this shift towards more stable plaques, but the physicians suspect that it is probably a combination of improved treatment and the measures taken to prevent the hardening of arteries, such as medication to lower cholesterol and blood pressure. The introduction of the smoking ban in public areas may also have had an impact.

The UMC Utrecht study has generated a great deal of interest from foreign colleagues. In the US and the UK, there have been fewer severe cerebral infarctions for years now, and the incidence of fatal heart attacks also seems to be decreasing in the Western world. Until now, scientists could only guess at the process driving these decreases. The UMC Utrecht study, which has found a trend towards more stable plagues, appears to have unraveled an important part of this mystery.

However, Prof. F Moll, head of Vascular Surgery at UMC Utrecht, cautions against undue optimism. “We have seen an increase in the rate of atherosclerosis among women, for instance. And the massive increase in obesity and diabetes could eventually undo much of this positive trend. So we cannot afford to rest on our laurels; we have to stay focused.”

Citation
Lammeren GW van, Ruijter HM den, Vrijenhoek JEP, Laan S van der, Velema E, Vries JPM de, Kleijn DPV de, Vink A, Borst GJ van de, Moll FL, Bots ML, Pasterkamp G. Time dependent changes in atherosclerotic plaque composition in patients undergoing carotid surgery. Circulation 2014, in press.

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