ABSTRACT

Inasmuch as approximately 75% of all adult deaths in western society are the consequence of occlusive arterial disease — atherosclerosis — there is an urgent need for a greater research effort to understand, prevent, treat, and provide early diagnosis than that which has been implemented in the recent past. Approximately ten million individuals within the U.S. alone suffer symptomatic coronary, cerebrovascular, and lower extremity arterial insufficiency. Nearly 1 of every 100 living Americans has suffered a stroke and their direct and indirect cost to the health care budget exceeds 10 billion dollars per year. More than 500,000 cardiovascular surgical and angioplastic procedures are performed annually in the U.S. In the 1982 report of the Research Training and Development Talk Group, 1 peripheral vascular disease was identified as an important area in which research funding has been relatively neglected. More research manpower was recommended in order to extend scientific and methodologic advances and improve our understanding and control of peripheral vascular disease. In this context, peripheral vascular disease includes occlusive disease of the large, small, and intermediate arteries of the extra- and intracranial vessels, the coronary arteries, and the arteries of the lower extremities as well as the prime arterial supply vessels to the major viscera. With relatively minor variations, the occlusive disease process and its consequences are basically the same in all of these organ systems. With new knowledge provided by cell biologists during the past 10 to 15 years, the development of sophisticated and reliable investigative methods such as biologic markers, the identification of many of the mechanisms governing the behavior of the endothelial and smooth muscle cell, the monocyte, tissue macrophage, and the platelets, as well as an enormous number of protein molecules populating this vascular milieu, there are now available, as never before, opportunities for an integrated, yet multidisciplined, approach to the study of atherosclerosis and the arterial wall.