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[Atherosclerosis regression and plaque stabilization: comparison of therapeutic targets].

Atherosclerosis is a systemic disease where atheromatous plaque is the basic lesion. A number of studies have shown that atherosclerotic lesions progress over time, when risk factors such as arterial hypertension and hyperlipidemia are present. Many clinical trials have been conducted in the last decade, both with antihypertensive and lipid-lowering drugs. These trials demonstrated that progression of atherosclerosis can be halted and even regression can be achieved. In studies with lipid-lowering drugs, the best results were achieved with a dramatic decrease in LDL cholesterol levels, obtained with statins, particularly when combined with a concomitant increase in HDL cholesterol. The treatment of hypertension provided better results on the endpoint atheromatous plaque with antihypertensive drugs belonging to the class of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers or calcium antagonists. Some studies were conducted both with antihypertensive and lipid-lowering drugs, and a better control of lesion progression, together with its partial regression, was obtained. The best approach seems to be achieved with the combination of a specific intervention on lipid profile together with a targeted control of blood pressure.