Atherosclerotic vascular disease conference. Writing group III: Pathophysiology

The existence of atherosclerosis has been recognized for over 500 years; as a pathological condition, it has been recognized for over 150 years. Understanding of atherosclerotic vascular disease {(AVD)} has evolved most dramatically over the past 25 years with the growth of the field of vascular biology.1 Numerous studies have described this disease as a diffuse and progressive process with a variable distribution and clinical presentation that is dependent on the regional circulation involved. Factors that may influence these differences include the size and structure of the affected artery, local and regional flow, changes in microcirculatory alterations, and end-organ damage. This report discusses the general concepts of atherosclerosis, pathophysiology, microcirculatory disturbances, regional responses to atherosclerosis and ischemia, and recommendations for future research, programs, and advocacy.