Protection of the Vascular Wall

If one accepts that arterial glycocalyx dysfunction is the first step in the atherothrombotic process, screening of asymptomatic subjects could detect this change. Measurement of the arterial dilatation in response to increased arterial flow (FMD) is widely used in research and would seem to be a possible general non-invasive screening test in humans. Once there has been a break-down of this first line of protection, the second step in the atherothrombotic process might be effectively detected by measurement of blood platelet-platelet and platelet-leukocyte aggregates. While there is no clear treatment to counteract the first step other than exercise programmes, there is evidence to suggest that effective treatment of the second step could be achieved using 5HT2A antagonism.