Brief Reviews: Hemodynamic Theories of Atherogenesis

Abstract

The growth of atherosclerotic plaques occurs at certain favored sites, in regions of low wall shear where the flow may be separated or turbulent and in regions of relatively high wall shear. Various hypotheses were proposed to correlate these sites with local flow conditions in the arterial system. These include the pressure-related hypothesis proposed by Texon, wall shear stress hypotheses, turbulance-related hypotheses and flow separation hypotheses. The relative merits of each hypothesis were discussed fluid dynamically. The validity of some models was shown to be highly questionable; other models, although not necessarily invalid, contain certain assumptions which have yet to be verified. To reconcile the differing viewpoints, it is necessary to develop some consensus about the sites at which atherosclerotic lesions first appear for both normal and hyperlipidemic conditions, to conduct further studies of mass transfer and flow behavior in the arterial system, and to clarify the significance of previous related model studies.