Directions of atherosclerosis research in the 1980s and 1990s

Several major achievements in cardiovascular research are likely to occur in the 1980s and 1990s. The lipid hypothesis should be settled once and for all: Does lowering levels of low-density lipoproteins prevent coronary artery disease? A new hypothesis will be tested and tried: Does increasing levels of high-density lipoproteins prevent coronary artery disease? We are likely to know the importance of modulations of the pathways of prostaglandin metabolism, of cyclooxygenase and thromboxane inhibitors, and of prostacyclin agonists. We should know the significance of vascular growth factors in promoting arteriosclerosis. Perhaps we will even learn the cause of arteriosclerosis. Sophisticated noninvasive methods will be able to detect arteriosclerosis early and to follow its progression. Therapy will be aimed at correcting the risk factors and at protecting the arterial wall despite the presence of risk factors. The use of laser beams or the injection of synthetic substances may dissolve atherosclerotic plaque. Replacement of damaged hearts with transplanted ones will be commonplace but limited to availability; a completely implantable artificial heart may be a reality.