174 Romanian Journal of MEDICAL PRACTICE Romanian JouRnal of medical PRactice – Vol. XV, no. 2 (71), 2020 Corresponding author: Robert Adrian Dumbrava, MD E-mail: zelrobert@gmail.com Shared risk factors for atherosclerosis and arteriosclerosis Assist. Prof. Claudia Floriana SUCIU 1 , MD, PhD student, Robert Adrian DUMBRAVA 2 , MD, Maria Andrada JIGA 2 , MD, Liviu CRISTESCU 2 , MD, Lecturer Andreea VARGA 1,2 , MD, PhD 1 Department ME2, Faculty of Medicine in English, G.E. Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures, Romania 2 Internal Medicine – Cardiology II Clinic, Emergency County Hospital, Targu Mures, Romania Abstract Atherosclerotic plaque ruptures with subsequent intraluminal thrombosis are the most prevalent causes of acute coronary syndromes, ischemic stroke, acute limb ischemia or cardiovascular death. Hyperlipidemia is no longer considered the primary cause of atherosclerotic disease, as recent data supports the involvement of other triggers such as age, excessive activation of sympathetic nervous system in arterial hypertension, and most importantly, inflammation. Arteriosclerosis is a consequence of interaction between similar mech- anisms resulting in arterial stiffening. Furthermore, wall stiffening resulted from the arteriosclerotic pro- cess is a risk factor for atherosclerotic disease. This unstructured literature review aimed to present the un- derlying remodelling processes and mechanisms for atherosclerosis and arteriosclerosis highlighting the common aspects of this two entities and the continuous interrelation that eventually leads to cardiovascular events. Keywords: atherosclerosis, arteriosclerosis, inflammation, sympathicotonia Ref: Ro J Med Pract. 2020;15(2) DOI: 10.37897/RJMP.2020.2.9 Scientific research INTRODUCTION In the last decades important steps forward have been made in understanding the pathogenesis of ath- erosclerotic disease, thus bringing us closer to the pos- sibility of preventing it’s most poignant consequences, namely acute coronary syndromes (ACS), ischemic stroke, acute limb ischemia or cardiovascular death. The most prevalent aforementioned entities are lumi- nal thrombosis following plaque rupture, plaque ero- sions and calcified nodules. Arteriosclerosis, an age-related degenerative change of the arterial wall characterized by arterial stiffening without lumen narrowing, represents a dis- tinct process from atherosclerotic disease; however, both pathologies coexist in the same arterial territory and share risk factors such as inflammation. Age-relat- ed chronic inflammatory changes in the arterial wall seem to be the basis of the linking mechanisms be- tween inflammation and arterial stiffness. ATHEROSCLEROSIS Atherosclerotic plaque disruption, superimposed atherothrombosis and subsequent vessel oclussion are responsible for most of the atherosclerotic cardio- vascular (CV) events (1). Disruption tends to occur in an plaque with a substantial necrotic core which rep- resents ≥ 30% of the entire plaque, covered by a thin fibrous cap of less than 65 µm (2). Inflammatory cells consisting primarily of macrophages and T-lympho- cytes are abundant in these lesions and the matrix metalloproteinases (MMP) released by macrophages