Diseases of the cardiovascular system include atherosclerosis, hypertension, coronary artery disease (CAD), rheumatic diseases, inflammatory heart diseases and heart defects, as well as congenital and acquired vascular diseases. Morbidity and mortality associated with these diseases is the highest. Atherosclerosis, hypertension and coronary artery disease are considered to be the main diseases of the 20th century, and they are still important in the 21st century.
The morphological basis and pathogenesis of these diseases became clear only in the early 20th century. Thus, the term “atherosclerosis” was proposed by Marchand in 1904, classified by N.N. Anichkov and S.S. Khalatov in 1913 as an independent disease. Myocardial infarction was first described in detail by V.P. Obraztsov and N.D. Strazhesko in 1909. Hypertension as a nosological entity was described in 1922 by G.F. Lang. I.V. Davydovsky called these “diseases of civilization”, an expression of human inability to adapt to the rapidly progressing urbanization and associated lifestyle changes with constant stress, environmental degradation and other features of the so-called civilized society.
However, not only cardiovascular impairment underlies cardiovascular system diseases. Indeed, this is an essential pathogenetic component in many conditions. Thus, arterial wall sclerosis, i.e. arteriosclerosis, develops in many diseases and plays an important role in their pathogenesis, with atherosclerosis being merely its variation. There are several types of arteriosclerosis:
- metabolic arteriosclerosis, or atherosclerosis;
- arteriolosclerosis, or hyalinosis (in hypertension);
- inflammatory arteriosclerosis (in syphilis, tuberculosis, etc.);
- allergic arteriosclerosis (polyarteritis nodosa);
- toxic arteriosclerosis (e.g., epinephrine-mediated);
- primary calcinosis of arterial media (Mönckeberg medial calcific sclerosis);
- age-related (senile) arteriosclerosis.