Preventative Aspects in Angina Pectoris

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Abstract
From our insight into pathogenesis of atherosclerosis there appear to be two processes at the root of it: a slow one and a fast one. The slow one consists of the formation of atheroma, mainly related to elevated serum cholesterol level and the second, fast phenomenon, is mainly due to thrombogenesis and vasoconstriction. For prevention it may be important to tackle both, but each of the processes has its own preventative approach. Primary prevention has now entered the practical field of cardiology in an impressive way with three trials providing us with positive results. International trends in coronary heart disease mortality are consistent with the theory which holds that a slightly elevated serum cholesterol level is a prerequisite for coronary atherosclerosis to develop. Hypertension and smoking aggravate that process once it has set in. As regards secondary prevention, a great number of recommendations can now be enumerated, and this has been done recently by the second workshop of the ISFC. Very recently, results have become available of different types of trials which try to evaluate the efficacy of lipid lowering by measuring the rate of change in arterial lesions as end points. Results of one such investigation, the Leiden Intervention Trial, is reported here and its findings suggest that dietary measures that aim at lowering cholesterol intake will reduce the likelihood of progression of coronary lesions in patients with angina pectoris.

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