Atherosclerosis is a disease of the blood vessels. It occurs when a material called plaque builds up on the inside walls of arteries. Over time, this plaque hardens, creating a narrowing of blood vessels that leads to a number of serious health problems.
Definition & Facts
Atherosclerosis is a blocking of arteries in the body that can cause serious consequences, such as heart attack, stroke, or kidney failure. Atherosclerosis affects the flow of blood through the body. It affects one in 58 people in the United States and is responsible for almost 15 percent of the deaths in the country.
The buildup of arterial plaque can affect any blood vessel in the body, which means that a number of organs of the body can be affected by diminished blood flow. Treatments focus on limiting the damage caused by arterial blockage, so that organs can receive the flow of oxygen and nutrients needed for normal function.
Symptoms & Complaints
- Angina (chest pain & tightening)
- Shortness of breath
- Heart arrhythmias
- Stroke symptoms, such as weakness, confusion, trouble speaking or understanding speech, severe headache, or loss of consciousness
- Numbness or pain in the arms and legs
- Kidney disease
A number of different conditions put one at a higher risk for developing atherosclerosis, including:
- Diabetes or insulin resistance
- Age: being over the age of 45 of one is male, and being over the age of 55 if one is female
- High blood pressure
- High cholesterol levels
- Poor diet and malnutrition
- Sedentary lifestyle
- Sleep apnea
- Alcoholics and binge drinkers
- Psychological stress
The exact mechanism of what causes atherosclerosis is not well understood. It appears to begin with cellular changes deep within the walls of blood vessels, which begin to accumulate the fatty, calcium-rich materials that make up plaque. Researchers believe that atherosclerosis may begin as early as childhood, gradually becoming more severe as people age. A genetic component is suspected, because it often runs in families.
Smoking, obesity, and problems with insulin appear to also play a part. High blood pressure and the presence of certain components in the blood, such as cholesterol and triglycerides also appear to be linked to risk for atherosclerosis.
Diagnosis & Tests
Physicians use a variety of tests to determine whether atherosclerosis is present. Blood tests indicate whether certain components are at high levels, which create a risk factor for atherosclerosis. A chest X-ray may be done to view the structures within the chest cavity. Angiograms use a dye and special X-rays to investigate the interior of the arteries.
An electrocardiogram measures electrical activity in the heart, the rhythm of heartbeats, as well as the strength and timing of electrical signals. An echocardiogram uses sound waves to create an image of the movements of the heart as it beats. It can also identify problems in blood flow to the heart.
Computer tomography (CT) scans provide an image of the heart that can show narrowing or blockages that have occurred. The physician may also order cardiac stress tests that provide information about the heart when the individual is engaged in activity. The test can show changes in rhythm or electrical signals.
Treatment & Therapy
The goal of treatment for atherosclerosis is to relieve symptoms that may have occurred and to reduce the amount of blockage in the arteries in order to prevent more serious consequences, such as heart attack or stroke. Educating patients in implementing a healthier lifestyle is an important part of treatment because it can help to reduce weight and cholesterol levels.
Therapeutic lifestyle changes (TLC) include a diet that provides less than 7 percent of saturated fat, such as that found in dairy products, meat and poultry. Foods high in soluble fiber are encouraged, as well as increased portions of vegetables that provide plant sterols. A number of medications are used to treat atherosclerosis, such as:
- Cholesterol medications – These drugs are used to reduce low-density lipoproteins (LDL) in the blood which play a part in the development of fatty deposits in arteries.
- Antiplatelet drugs – These medications, such as aspirin, to reduce the risk that platelets will clump within the arteries, causing a blockage.
- Beta blockers – These drugs lower blood pressure and heart rate to reduce the strain on the heart muscle.
- Diuretics (water pills) – These drugs lower blood pressure, one of the major risk factors for heart attack and stroke.
- Calcium channel blockers – These medications are also used to lower blood pressure and can be helpful in reducing discomfort of angina.
- Angiotensin-converting enzyme inhibitors (ACE inhibitor) - These drugs lower blood pressure and improve function in the arteries of the heart.
In some cases, cardiac surgery is indicated to open a blockage or improve blood flow. Several different procedures are used:
- Angioplasty and stent placement uses a balloon-like device to open up a blocked artery and uses a flexible stent to hold the artery open.
- Endarterectomy surgically removes the fatty deposits in the artery to allow better blood flow.
- Fibrinolytic therapy uses drugs to dissolve blood clots that may have formed.
- Bypass surgery uses a blood vessel from another part of the body to create a bypass around a blocked area.
Prevention & Prophylaxis
Management of diabetes can also prevent the damage done to blood vessels. Annual visits to your doctor for a physical examination and blood testing can help to address medical issues early in the process to prevent atherosclerosis from worsening.