Atherosclerosis is a chronic inflammatory process in which the accumulation of cholesterol-laden plaque restricts blood flowin the arterial vasculature. The occlusion of arteries by expanding plaque or emboli from plaque rupture or erosion underlies a variety of cardiovascular diseases including myocardial infarction, ischemic cardiomyopathy, stroke, and peripheral vascular disease. Although cardiovascular disease remains a leading cause of morbidity and mortality in high-income countries, an epidemiological shift has occurred in recent decades.^, Improvements in vaccination and treatment of infectious diseases have led to a notable increase in the prevalence of cardiovascular diseases in low- and middle-income nations.

The prominent and increasing burden of atherosclerotic cardiovascular disease has stimulated growing interest in the elucidation of its pathogenesis, risk factors, prevention, and treatments. There has been remarkable progress in the understanding of atherosclerosis pathophysiology, and new risk factors, in addition to traditional ones, have been described to be implicated, including disturbed sleep, physical inactivity, the microbiome, the microbiota and gender-related factors. Also, knowledge about the importance and possibility of its early prevention, preferably during childhood or even earlier in pregnancy, and about optimized treatment by non-pharmacological therapies, pharmacotherapy, and/or interventional procedures, has expanded, tremendously; but even so, atherosclerotic cardiovascular disease remains the number one killer in the world.

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