Atherosclerosis

By:    Published: February 16, 2012

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Atherosclerosis, also known as hardening of the arteries, is a silent killer. Many have died due to fatal complications of atherosclerosis. According to the American Heart Association (AHA), it is estimated that each year more than three quarters of a million people will have a first heart attack and nearly half of those will go on to have a second, all as a result of complications of atherosclerosis, and shockingly, most people don’t know they have it until it’s too late.

Definition

Atherosclerosis comes from the Greek words “athero,” which means gruel or paste and “sclerosis,” which means hardness. This accurate name describes a condition in which plaque adheres to the arteries, leading to serious health problems like heart attack or stroke.

Plaque is a sticky substance that is made of fat, cholesterol, calcium and other substances found in the blood. There are two types of plaque, stable and unstable.

  • Stable plaque has a thick fibrous cap that is made of smooth muscle cells.
  • Unstable plaque is much more dangerous because the cap is much thinner. Because of this, the cap can rupture allowing the plaque to travel elsewhere in the body causing a life-threatening heart attack, stroke or embolism.

According to the AHA, by the age of 35, two out of three Americans will have some kind of plaque buildup in their arteries. But atherosclerosis is a slow, progressive condition. The problem often goes unnoticed until a larger problem develops later in life.

Causes

There are a number of causes of atherosclerosis. Some are controllable and some are not. They include:

  • Age
  • Family history
  • High blood pressure
  • High LDL cholesterol
  • Smoking
  • Lack of physical activity
  • Obesity
  • Poor diet
  • Diabetes

While there is no way to change age or family history, beneficial lifestyle choices such as eating a healthy diet, getting regular physical exercise and quitting smoking can lower the risk of developing atherosclerosis.

Symptoms

Atherosclerosis often goes without symptoms in the early stages. Symptoms typically only appear once the blockage becomes severe enough to significantly affect blood flow. Often, people don’t’ now that there is a problem until they have a heart attack or stroke.

If symptoms do appear, they usually reflect the arteries that are affected.

Coronary Arteries supply oxygen-rich blood to the heart. If the coronary arteries are affected symptoms can include:

  • Angina (chest pain, but can also be felt in the left arm, neck, back and jaw)
  • Shortness of breath
  • Arrhythmias
  • Fatigue
  • Sleep problems

Carotid arteries supply blood to the brain. Blockages of these arteries can cause a stroke. If the carotid arteries are affected symptoms can include:

  • Sudden weakness
  • Paralysis on one or both sides of the body
  • Confusion
  • Trouble speaking or understanding speech
  • Vision problems
  • Trouble breathing
  • Dizziness
  • Loss of balance and coordination
  • Loss of consciousness
  • Severe headache

Peripheral arteries carry blood to the extremities. Symptoms can include:

  • Numbness
  • Pain
  • Infections
  • Cold hands or feet

Renal arteries supply blood to the kidneys. Blockages of these arteries can lead to chronic kidney disease and, over time, loss of kidney function. Symptoms typically don’t appear until the problem is serious and includes:

  • Changes in urination,
  • Loss of appetite
  • Nausea
  • Tiredness
  • Swelling in the hands and feet
  • Itchiness or numbness
  • Trouble concentrating

Related Conditions

Atherosclerosis is the leading cause of a number of conditions, including;

  • Coronary Artery Disease (CAD): this causes decreased blood flow to the heart and can lead to heart attack
  • Stroke
  • Abdominal angina: a type of abdominal pain caused by the narrowing of the vessels that supply blood to the intestines
  • Bowel infarction: similar to a heart attack, but affects the intestines. It is caused by a sudden interruption in blood flow to the intestines.
  • Atherosclerosis of the extremities: 80 to 90 percent of people with atherosclerosis are also affected in the extremities. This can lead to crampy leg pain and coldness. If severe enough it can lead to gangrene or tissue necrosis.
  • Aortic aneurysm: this is the bulging of a weak point caused by a blockage in the wall of the aorta, usually in the thoracic cavity. This bulging weak point can rupture, causing massive internal bleeding, and often death.
  • Renal artery stenosis: the narrowing of the artery that supplies blood to the kidney. This can cause high blood pressure and severely impair kidney function.

Prevention

Atherosclerosis can be treated in a number of ways including lifestyle changes, medication and procedures, both surgical and non-surgical. A doctor will usually choose the least invasive option for the patient, based on their individual case.

Lifestyle changes are the low tech way to reduce the risk of developing atherosclerosis, or to reduce the chances that it will worsen. Perhaps the most important change that someone can make is quitting smoking. Smoking has a whole host of negative effects on the body, including making blood stickier, which worsens atherosclerosis. Other changes include eating a healthy diet that is low in fat, sugar and excess calories and rich in fruits and vegetables, and getting at least 30 minutes of exercise most days of the week. Exercise doesn’t need to be complicated and doing simple things like housework or walking is effective. (For ideas on 30-minute exercises, read 30-Minute Workout Routines For Your Lunch Break.)

Treatment

Medications are often used with lifestyle changes to help treat atherosclerosis. The medications can do a number of things, and a doctor will determine which medications will be best based on the individual situation. These include:

  • Statin medications designed to reduce the amount of cholesterol in the blood
  • High blood pressure medications
  • Anti-platelet medications such as aspirin or clopidogrel
  • Cilostazol to help those with leg pain be able to walk farther without pain

If these treatment options are not enough, the doctor may recommend surgical or non-surgical procedures to help restore circulation. This could be something as simple as an outpatient stent procedure in which a device is inserted into the blood vessel to help restore circulation, or as drastic as a bypass procedure. Only a doctor can determine which procedure will provide the most benefit.

Atherosclerosis is not inevitable. By living a healthy and active lifestyle, people can dramatically reduce the risk of developing this potentially life threatening problem.

Sources:

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