asymptomatic hypertension. Individuals at risk include those with a family history of heart attack (fatal nonfatal) or angina prior to age 60; LDL cholesterol greater than 100 mg/dl; HDL cholesterol less than 0.9 mg; and it should be prescribed at the initial diagnosis of diabetes. In addition beta-blockers have been shown to prevent sudden death in patients with coronary artery disease and may prevent plaque rupture. The salutary effects of beta blockade are given in Fig. 1, the chapter Beta-Blockers. Figure 6 summarizes the major factors involved in the genesis of atheroma and the resultant cardiovascular events.
Prevention of atheroma formation and its dangerous consequences require treatment of the initiating factor, turbulent blood flow and optimal treatment of the five reasons that cause progression of the atheromatous lesion. Today’s medicine does not address the treatment of turbulent blood flow (hyper- and hydrodynamic) factors that in all probability initiate the atheromatous lesion. A combined strategy of reduced turbulence in arteries and the reduction of LDL-C to less than 2.0 mmol/L (80 mg/ dl) with an increase in HDL-C to greater than 1.5 mmol/L (60 mg/dl) may have salutary effects.

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