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The clinical morphology of human atherosclerotic lesions. Lessons from the PDAY Study. Pathobiological Determinants of Atherosclerosis in Youth.

The PDAY study addresses the role traditional risk factors play in the development and progression of arterial lesions in youth (15 to 34 years of age). This autopsy based study indicates that in the aorta and in the right coronary artery, atherosclerosis is positively associated with cholesterol (LDL+VLDL), glucose intolerance, smoking, hypertension, and obesity and negatively associated with HDL-cholesterol. When a high cholesterol group (> 240 mg/dl) is compared to a low cholesterol group (< 200 mg/dl) early fatty sudanophilic lesions decrease in the aorta from 35% to 29% (p < 0.03) surface area, while raised atherosclerotic lesions are lowered (from 5%) in the high cholesterol group (to 3%) in the low cholesterol group; p < 0.02). Clearly, risk factors particularly cholesterol levels, directly affect the development of atherosclerosis in the coronary arteries and the aorta of young people. The data presented suggest that risk factor modification would be beneficial in young people as from 15 years of age.