Atherosclerotic plaque reduction: blood pressure, dyslipidemia, atherothrombosis.

Coronary heart disease (CHD) is one of the leading causes of morbidity and mortality worldwide and modification of established cardiovascular risk factors has become increasingly important in order to minimize the impact of the disease. In response to the considerable debate regarding the optimal use of therapeutic strategies, a range of biomarkers has been incorporated into clinical development programs in order to ascertain the efficacy of novel agents. In addition, technological advances in imaging of the artery wall now enable the quantification of the extent of atherosclerotic plaque and allow monitoring of serial changes in response to therapeutics. The most sensitive imaging modality to date is intravascular ultrasound (IVUS) which can determine and quantitate atheroma burden and has provided insights regarding the pathophysiology of plaque formation and the potential impact of new antiatherosclerotic therapies. Furthermore, serial IVUS has demonstrated that intensive modification of a number of established risk factors such as lipid levels and blood pressure has a beneficial impact on the rate of disease progression in patients with established CHD.