Disease: Atherosclerosis

What Is Atherosclerosis?

Atherosclerosis is a leading cause of death among American adults.

You may have heard of the condition commonly known as "hardening of the arteries."

It occurs when your blood vessels thicken or stiffen, and it’s actually a serious form of heart disease — specifically, coronary artery disease (CAD) — called arteriosclerosis.

Atherosclerosis is perhaps the most common type of arteriosclerosis, although the two terms are often used interchangeably.

Specifically, atherosclerosis refers to a condition in which deposits of cholesterol, fat, calcium, and blood elements (collectively called "plaque") build up in the arteries, causing them to narrow.

Arteriosclerosis and atherosclerosis can affect any arteries throughout the body. When the arteries that feed the heart muscle are affected, the condition is called coronary artery disease, or CAD.

According to the Centers for Disease Control and Prevention (CDC), more than 370,000 people in the United States die annually as a result of CAD, making it the most common type of heart disease and the number-one cause of death for both men and women.

Although conditions such as atherosclerosis are more common in the elderly, a recent study found that plaque accumulation occurs in more than 10 percent of American adults between the ages of 29 and 51.

What Causes Atherosclerosis?

The exact cause of atherosclerosis isn’t known.

However, research indicates that it’s a complex disease that may start in childhood, and worsen as you age.

Atherosclerosis may be caused by damage to the inner layers of the arteries, where plaque typically accumulates.

This damage has been linked to:

  • Smoking
  • High quantities of fat and/or cholesterol in the blood
  • High blood pressure (hypertension)
  • High blood sugar levels (due to diabetes)

An area of plaque accumulation may cause an artery to rupture or break open. When this occurs, blood platelets may clump together at the site of the injury and form blood clots.

These clots can narrow the artery even more, limiting the flow of oxygen- and nutrient-rich blood to your body.

Depending on which arteries are affected, blood clots can cause angina or, worse, a heart attack or stroke.

Who Is at Risk for Atherosclerosis?

Risk factors for atherosclerosis include:

  • High levels of LDL ("bad") cholesterol and/or low levels of HDL ("good") cholesterol
  • High blood pressure
  • Smoking
  • Insulin resistance and/or diabetes
  • Overweight or obesity
  • Lack of physical activity
  • Unhealthy diet

In men, the risk for atherosclerosis increases after age 45; in women, the risk increases after age 55.

Risk for atherosclerosis also increases if your father or a brother was diagnosed with heart disease before 55 years of age, or if your mother or a sister was diagnosed with heart disease before 65 years of age.

In addition, recent research suggests that high levels of a protein called C-reactive protein (CRP) in blood may increase the risk for atherosclerosis.

Complications Associated with Atherosclerosis

The complications associated with atherosclerosis depend on which arteries are blocked.

For example, when atherosclerosis narrows the arteries close to your heart, you may develop CAD, which can cause chest pain (angina), a heart attack, or heart failure.

When atherosclerosis narrows the arteries close to your brain, you may develop carotid artery disease, which can cause a transient ischemic attack (TIA) or stroke.

Narrowing of the renal (kidney) arteries can cause chronic kidney disease.

When atherosclerosis narrows the arteries in your arms or legs, you may develop circulation problems in your arms and legs called peripheral artery disease.

Finally, atherosclerosis can also cause an aneurysm, a serious complication that can occur anywhere in your body.

When the wall of an artery is weakened due to atherosclerosis or other factors, it may develop a bulging area, called an aneurysm.

While most people with aneurysms have no symptoms, if the weak area bursts, it can be life-threatening.

Sources:

  • Arteriosclerosis; Mayo Clinic
  • Coronary Artery Disease; CDC
  • Kelley et al (2011). "Prevalence of Atherosclerotic Plaque in Young and Middle-aged Asymptomatic Individuals." Southern Medical Journal
  • What Is Atherosclerosis? NIH

Symptoms of Atherosclerosis

Early diagnosis of atherosclerosis can prevent serious complications.

Atherosclerosis develops gradually, and those with mild forms of the disease may not experience any symptoms at all.

Many people with atherosclerosis don’t know they have the condition until their arteries are so narrowed or clogged they can’t supply adequate blood to their organs and tissues.

If symptoms do occur, their location and severity generally depend on the blood vessels affected.

Common symptoms of atherosclerosis include:

  • Chest pain (angina)
  • Pain in the leg, arm, and anywhere else that an artery is blocked
  • Shortness of breath
  • Fatigue
  • Confusion (if the blockage affects circulation to the brain)
  • Muscle weakness in the legs from lack of circulation

If you have atherosclerosis in your heart arteries, you may have symptoms, such as chest pain or pressure (angina).

Similarly, if you have atherosclerosis in the arteries leading to your brain, you may experience sudden numbness or weakness in your arms or legs, difficulty speaking or slurred speech, or drooping muscles in your face.

These signal a transient ischemic attack (TIA) and, if they are left untreated, may progress to a stroke.

If you have atherosclerosis in the arteries in your arms and legs, meanwhile, you may have symptoms of peripheral artery disease. These symptoms include leg pain when walking.

Finally, atherosclerosis can also affect the arteries leading to your kidneys or genitals, resulting in kidney failure or erectile dysfunction, respectively.

Early diagnosis and treatment of atherosclerosis can prevent serious complications such as angina (chest pain), irregular heartbeat, heart attack, or stroke.

If you think you have atherosclerosis, talk to your doctor immediately, as it’s a serious health condition.

How Is Atherosclerosis Diagnosed?

During a routine physical exam, your doctor may find signs of narrowed or hardened arteries such as:

  • Weak or absent pulse in the area of the affected artery
  • Decreased blood pressure in an affected limb
  • “Whooshing sounds” or “bruits” over the affected arteries (heard with a stethoscope)
  • Signs of an aneurysm in your abdomen or behind your knee
  • Evidence of poor wound healing in the affected area

Depending on the results of the physical exam, your doctor may suggest some or all of the following diagnostic tests:

  • Blood tests to detect increased levels of cholesterol and blood sugar
  • Doppler ultrasound to evaluate blood flow through arteries
  • Ankle-brachial index
  • Electrocardiogram (ECG)
  • Stress test or exercise stress test
  • Cardiac catheterization and angiogram
  • Computerized tomography (CT) scan
  • Magnetic resonance angiography (MRA)

Blood tests can detect increased levels of cholesterol and blood sugar while Doppler ultrasound is used to measure your blood pressure at various points along your arm or leg and identify blockages.

Your doctor may take your blood pressure at your ankle and in your arm.

Dividing the arm blood pressure into the ankle blood pressure gives a result called the ankle-brachial index, which can be used to predict the chance that someone will have a heart attack or other event, as well as the risk of death from such events.

He or she may also recommend an electrocardiogram to see if you’ve had a heart attack, as you may have a mild heart incident without even knowing it.

Stress or exercise stress tests are also common, as they can help your doctor gather information about how well your heart works during physical activity.

This test usually involves walking on a treadmill or riding a stationary bike while your heart rhythm and blood pressure and breathing are monitored.

An echocardiogram is a type of ultrasound test that shows heart structure and function.

Your doctor may recommend a cardiac catheterization and angiogram to see if your coronary arteries are narrowed or blocked.

They can also use computerized tomography (CT) scan or magnetic resonance angiography (MRA) to study your arteries.

Sources:

  • Arteriosclerosis; Mayo Clinic
  • What Is Atherosclerosis? NIH

Treatments for Atherosclerosis

Atherosclerosis treatment options include prescription medicine, surgery, and home remedies and alternative therapies.

Atherosclerosis, or "hardening of the arteries," occurs when deposits called plaque buildup in the arteries, causing them to harden and narrow.

Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood.

There are many proven approaches for the treatment and prevention of atherosclerosis.

How to Prevent Atherosclerosis

Lifestyle changes can reduce the risk of atherosclerosis, and are generally the first-line treatment for people diagnosed with the condition.

For example, you can practice relaxation techniques, such as yoga or deep breathing, to help you relax and reduce your stress level.

These practices can temporarily reduce your blood pressure, lowering your risk of developing atherosclerosis.

Dietary changes can also have a positive effect in reducing risk for atherosclerosis.

Experts suggest incorporating seeds, grains, vegetables, fruits, and nuts as well as sunflower oil, olive oil, and flax seed oil into your diet.

They also suggest eating smaller portions in more frequent intervals as opposed to eating fewer, larger meals.

In general, you should minimize the intake of cream, ghee, animal fats, and butter, and avoid meat, sauces, tea, white sugar, processed food, coffee, condiments, and pickles whenever possible.

Finally, as it’s a known risk factor for atherosclerosis, if you smoke, you should quit smoking as soon as possible.

Smoking damages the arteries and causes them to constrict. Smoking significantly worsens the progression of atherosclerosis, and has also been linked to hypertension (high blood pressure).

Medications for Atherosclerosis

Several drugs have been shown to slow or even reverse the progression of atherosclerosis, including:

  • Statins and fibrates
  • Blood thinners, such as aspirin, anti-platelet medications and anti-coagulant medications
  • High blood pressure medications, such as beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, calcium channel blockers, and angiotensin II receptor blockers
  • Diuretics
  • Thrombolytic therapy

Statins and fibrates reduce your low-density lipoprotein (LDL) or "bad" cholesterol, which can stop or even reverse the buildup of fatty deposits in your arteries.

In addition to lowering cholesterol, statins can help stabilize the lining of your heart arteries and prevent atherosclerosis.

Aspirin and other anti-platelet medications, meanwhile, can reduce the likelihood that blood clots will block flow through vessels.

Beta-blockers are used to treat coronary artery disease; they lower your heart rate and relax blood vessels, which in turn lowers blood pressure, reducing the risk for heart attacks and some heart rhythm problems.

Similarly, angiotensin-converting enzyme inhibitors (ACE inhibitors) may help slow the progression of atherosclerosis by lowering blood pressure and relaxing blood vessels, and reducing the risk for recurrent heart attacks.

Calcium channel blockers lower blood pressure and relax blood vessels. They are sometimes used to treat angina, and diuretics also lower blood pressure (high blood pressure is a risk factor for atherosclerosis).

Finally, thrombolytic therapy is designed to dissolve blood clots.

Your doctor may also recommend medications to control specific risk factors for atherosclerosis, including diabetes.

Surgical Approaches to Atherosclerosis

If you have severe symptoms of atherosclerosis, or your condition does not respond to medication, you may be a candidate for surgery.

Surgical procedures used to treat atherosclerosis include:

  • Angioplasty and stent placement
  • Endarterectomy
  • Bypass surgery (coronary artery bypass graft, or CABG)

In angioplasty, the surgeon inserts a catheter into the blocked or narrowed artery and places a second catheter with a deflated balloon tip through it.

The balloon is then inflated, compressing the deposits against your artery walls and a stent is usually placed in the artery to keep it open.

In endarterectomy, fatty deposits are surgically removed from the walls of a narrowed artery.

Finally, in CABG surgery, a surgeon bypasses a blocked artery by using a vessel from another part of your body or a tube made of synthetic fabric to detour around the blockage.

This allows blood to flow around the blocked or narrowed artery.

Home Remedies and Alternative Therapies to Treat Atherosclerosis

There’s some evidence — anecdotal as well as clinical — that suggests certain foods and herbal supplements might help reduce high LDL cholesterol and blood pressure, two risk factors for atherosclerosis.

However, you should talk to your doctor before adding any of them to your atherosclerosis treatment because they may be ineffective.

Additionally, they may interact with prescription medications, causing harmful side effects.

These include:

  • Alpha-linolenic acid
  • Artichoke
  • Barley
  • Beta-sitosterol
  • Blond psyllium
  • Calcium
  • Cocoa
  • Cod liver oil
  • Coenzyme Q10
  • Garlic and onions
  • Oat bran
  • Omega-3 fatty acids
  • Sitostanol
  • Vitamin C
  • Lemon peel

Many of these products are available in commonly available over-the-counter supplements.

Sources:

  • Arteriosclerosis; Mayo Clinic
  • Tomey et al. Advances in the Understanding of Plaque Composition and Treatment Options: Year in Review, Journal of the American College of Cardiology
  • Home Remedies for Atherosclerosis; Organic Facts

Source: http://www.everydayhealth.com

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