The formation of atherosclerotic plaques within arteries underlies most forms of cardiovascular disease (CVD). Atherosclerosis is a chronic inflammatory disease in which inflammatory cells (e.g. leukocytes) and lipids accumulate to form a plaque within the artery wall, underneath the endothelial cells which line the vessel. Despite a wide range of systemically acting risk factors, such as high cholesterol, plaques are not distributed evenly throughout blood vessels. Plaques tend to form in regions of the arterial tree where there are bends or where the vessels fork into branches. In 1969, Colin Caro and colleagues made the observation that these areas of plaque formation were associated with low or altered blood flow.1 This led to the idea that mechanical forces might play a role in lesion development. In recent years researchers have started to investigate and understand the molecular mechanisms underlying plaque formation, bringing Caro’s findings into sharp relief.
The endothelium is ...
