In the elderly, atherosclerotic diseases such as
stroke and
myocardial infarction occupy a major part of their causes of death and care. The elderly always have
atherosclerosis in their aorta and other arteries and are exposed to risk of attacks. It is the elderly who should receive its safe, harmless and advanced treatment. Advanced stage of
atherosclerosis in the elderly is progressed by complicated risk factors such as
dyslipidemia and
diabetes mellitus and specific risk factors for the elderly, aging (and menopause). Treatment of atherosclerotic disease may need special ones targeted for the elderly. Recent studies reported that frequencies of
dyslipidemia were not decreased in the older oldest. In the elderly,
impaired glucose tolerance occurs and it progresses
atherosclerosis. Endothelial dysfunction like impairment of
nitric oxide (NO) bioavailability also progresses
atherosclerosis. Although we tried to regress the high
cholesterol diet-induced
atherosclerosis in rabbit aorta with a normal diet with or without
statin, regression could not be achieved. NO targeting gene therapy (adenovirus
endothelial nitric oxide synthase [eNOS] gene vector) regressed 20% of atherosclerotic lesions through reduction of
lipid contents, however, a more integrated strategy is important for complete regression. We paid attention to NO bioavailability and developed two ways of increasing it in
atherosclerosis:
citrulline therapy and
arginase II inhibition by
estrogen. Further, we found a close relation between
atherosclerosis and endothelial senescence and that NO can prevent it, especially in a diabetic model. Taken together, regression of
atherosclerosis can be achieved by not only regulation of various risk factors but regulation of the cross-talk of NO and
free radicals.