Is it time to look at the arterial wall for prevention? Anatomy and function by ultrasound beyond flow mediated dilatation

Cardiovascular diseases can have unforeseen complications, which are sometimes their first and serious manifestation: myocardial or cerebral infarction or even sudden death.Population-based cardiovascular risk tables provide guidance in determining risk, 6 but do not determine whether it will occur in a given individual. In less educated and socio economically deprivated populations, the risk could be underestimated in half of the persons. herosclerosis, the most frequent cause of premature and avoidable death, passes for years asymptomatically, with anatomical and functional damage to the arterial walls. The unrepaired damage to our body at the molecular, cellular, tissue and organic levels, which develops throughout life and accelerates towards the fourth decade, determines the rate of aging and predisposes to diseases and their complications. Conventional cardiovascular studies, which are done on a daily basis, such as physical or pharmacological stress studies to detect myocardial ischemia, are of great value in the diagnosis and management of symptomatic diseases, but they do not usually detect atherosclerosis when it is asymptomatic, which it could be the optimal time for prevention.