Understanding the Complex Interplay of Epigenetic Factors in Atherosclerosis: A Review
Authors: Muralidhara Akshay , Aasaithambi Kalaiselvi , Nizam Imrankhan , Srinivasan Asha , Chidambaram Saravana Babu , Thaggikuppe Krishnamurthy Praveen , V. Madhunapantula Subba Rao , Thimmulappa Rajesh , Satyanarayana Reddy Karri Veera Venkata , Kuppusamy Gowthamarajan 
Published: October 2024

This review focuses on the epigenetic factors that play a vital role in the formation of plaques and lead to atherosclerosis and related diseases in humans during current times. Apart from the epigenetics there are plenty more factors that influence the atherosclerotic risk in the older population of the current era. Lack of physical activities has become one of the most commonly found traits that causes obesity in people especially the middles aged adults. People working 9 - 5 in an office, or an IT firm tend spend idle time with their computer for 4 - 5 consecutive hours with barely changing their position. Lack of exercise tends to affect not only the physical health but also stress a person mentally. Chronic inflammatory diseases like atherosclerosis have a major role in the morbidity and mortality from cardiovascular disease worldwide. Atherosclerotic plaques are created by the pathophysiological process of lipids, inflammatory cells and fibrous components gradually accumulating within artery walls. Endothelial dysfunction signals the start of atherosclerosis and allows low-density lipoproteins (LDL) to enter the subendothelial region. Oxidative stress-induced changes in retained low-density lipoprotein (LDL) set off an inflammatory cascade that draws T cells and monocytes to the site of the lesion. The interaction of these immune cells with the local vascular cells encourages the production of foam cells, which fills the plaque’s centre with lipids. Smooth muscle cells multiply and help produce fibrous caps as the lesion ages, which affects the stability of the plaque. Studies shows how the brain responds to physical labour and how differently the effectively the enzymes and hormones are secreted, and their actions are vastly guided based on the physical stress an individual undergoes. Among the most prominent causes of atherosclerosis epigenetics has been focussed majorly in this review, where we focus on the underlying genetic factors that play a vital role in atherosclerosis and related cardiovascular diseases and also the genetic approach to a treatment is also elaborated. A number of miRNAs are involved in the cause/cure for the atherosclerosis, the following tables give an outlook regarding the same.  This review aims to focus on the causes, risk factors, pathophysiology and the treatment and therapies that are currently available all the way concentrating on the genetic approach in the above-mentioned perspective.
HIGHLIGHTS

The review revolves around the modifiable and non-modifiable risk factors leading to atherosclerosis.
Key risk factors and epigenetics causes of atherosclerosis and atherosclerosis related Cardio vascular Diseases (CVD).
The article explains in detail regarding the pathophysiology of atherosclerosis.
The progression and stages of atherosclerosis.

GRAPHICAL ABSTRACT