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INTRODUCTION-
Arteriosclerosis occurs when the blood vessels that carry oxygen and nutrients from your heart to the rest of your body (arteries) become thick and stiff — sometimes restricting blood flow to your organs and tissues. Healthy arteries are flexible and elastic, but over time, the walls in your arteries can harden, a condition commonly called hardening of the arteries.
Atherosclerosis is a specific type of arteriosclerosis, but the terms are sometimes used interchangeably. Atherosclerosis refers to the buildup of fats, cholesterol and other substances in and on your artery walls (plaque), which can restrict blood flow.
The plaque can burst, triggering a blood clot. Although atherosclerosis is often considered a heart problem, it can affect arteries anywhere in your body. Atherosclerosis may be preventable and is treatable.
Atherosclerosis is a narrowing of the arteries caused by a buildup of plaque. Arteries are the blood vessels that carry oxygen and nutrients from your heart to the rest of your body.
As you get older, fats, cholesterol, and calcium can collect in your arteries and form plaque. The buildup of plaque makes it difficult for blood to flow through your arteries. This buildup may occur in any artery in your body, including your heart, legs, and kidneys.
It can result in a shortage of blood and oxygen in various tissues of your body. Pieces of plaque can also break off, causing a blood clot. If left untreated, atherosclerosis can lead to heart attack, stroke, or heart failure.
Atherosclerosis is a fairly common problem associated with aging. This condition can be prevented and many successful treatment options exist.
CAUSES-
Plaque buildup and subsequent hardening of the arteries restricts blood flow in the arteries, preventing your organs and tissues from getting the oxygenated blood they need to function.
The following are common causes of hardening of the arteries:
High cholesterol
Cholesterol is a waxy, yellow substance that’s found naturally in the body as well as in certain foods you eat.
If the levels of cholesterol in your blood are too high, it can clog your arteries. It becomes a hard plaque that restricts or blocks blood circulation to your heart and other organs.
Diet
It’s important to eat a healthy diet. The American Heart Association (AHA) recommends that you follow an overall healthy dietary pattern that stresses:
- a wide range of fruits and vegetables
- whole grains
- low-fat dairy products
- poultry and fish, without skin
- nuts and legumes
- non-tropical vegetable oils, such as olive or sunflower oil
Some other diet tips:
- Avoid foods and drinks with added sugar, such as sugar-sweetened beverages, candy, and desserts. The AHA recommends no more than 6 teaspoons or 100 calories of sugar a day for most women, and no more than 9 teaspoons or 150 calories a day for most men.
- Avoid foods high in salt. Aim to have no more than 2,300 milligrams (mg) of sodium per day. Ideally, you’d consume no more than 1,500 mg a day.
- Avoid foods high in unhealthy fats, such as trans fats. Replace them with unsaturated fats, which are better for you. If you need to lower your blood cholesterol, reduce saturated fat to no more than 5 to 6 percent of total calories. For someone eating 2,000 calories a day, that’s about 13 grams of saturated fat.
Aging-
As you age, your heart and blood vessels work harder to pump and receive blood. Your arteries may weaken and become less elastic, making them more susceptible to plaque buildup.
SYMPTOM-
Atherosclerosis develops gradually. Mild atherosclerosis usually doesn’t have any symptoms.
You usually won’t have atherosclerosis symptoms until an artery is so narrowed or clogged that it can’t supply adequate blood to your organs and tissues. Sometimes a blood clot completely blocks blood flow, or even breaks apart and can trigger a heart attack or stroke.
Symptoms of moderate to severe atherosclerosis depend on which arteries are affected. For example:
- If you have atherosclerosis in your heart arteries, you may have symptoms, such as chest pain or pressure (angina).
- If you have atherosclerosis in the arteries leading to your brain, you may have signs and symptoms such as sudden numbness or weakness in your arms or legs, difficulty speaking or slurred speech, temporary loss of vision in one eye, or drooping muscles in your face. These signal a transient ischemic attack (TIA), which, if left untreated, may progress to a stroke.
- If you have atherosclerosis in the arteries in your arms and legs, you may have symptoms of peripheral artery disease, such as leg pain when walking (claudication).
- If you have atherosclerosis in the arteries leading to your kidneys, you develop high blood pressure or kidney failure.
When to see a doctor
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If you think you have atherosclerosis, talk to your doctor. Also pay attention to early symptoms of inadequate blood flow, such as chest pain (angina), leg pain or numbness.
Early diagnosis and treatment can stop atherosclerosis from worsening and prevent a heart attack, stroke or another medical emergency.
Risk factors
Hardening of the arteries occurs over time. Besides aging, factors that increase the risk of atherosclerosis include:
- High blood pressure
- High cholesterol
- Diabetes
- Obesity
- Smoking and other tobacco use
- A family history of early heart disease
- Lack of exercise
- An unhealthy diet
DIAGNOSIS-
Your doctor will perform a physical exam if you have symptoms of atherosclerosis. They’ll check for:
- a weakened pulse
- an aneurysm, an abnormal bulging or widening of an artery due to weakness of the arterial wall
- slow wound healing, which indicates a restricted blood flow
A cardiologist may listen to your heart to see if you have any abnormal sounds. They’ll be listening for a whooshing noise, which indicates that an artery is blocked. Your doctor will order more tests if they think you may have atherosclerosis.
Tests can include:
- a blood test to check your cholesterol levels
- a Doppler ultrasound, which uses sound waves to create a picture of the artery that shows if there’s a blockage
- an ankle-brachial index (ABI), which looks for a blockage in your arms or legs by comparing the blood pressure in each limb
- a magnetic resonance angiography (MRA) or a computed tomography angiography (CTA) to create pictures of the large arteries in your body
- a cardiac angiogram, which is a type of chest X-ray that’s taken after your heart arteries are injected with radioactive dye
- an electrocardiogram (ECG or EKG), which measures the electrical activity in your heart to look for any areas of decreased blood flow
- a stress test, or exercise tolerance test, which monitors your heart rate and blood pressure while you exercise on a treadmill or stationary bicycle
Complications
The complications of atherosclerosis depend on which arteries are blocked. For example:
- Coronary artery disease. When atherosclerosis narrows the arteries close to your heart, you may develop coronary artery disease, which can cause chest pain (angina), a heart attack or heart failure.
- Carotid artery disease. 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.
- Peripheral artery 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. This can make you less sensitive to heat and cold, increasing your risk of burns or frostbite. In rare cases, poor circulation in your arms or legs can cause tissue death (gangrene).
- Aneurysms. Atherosclerosis can also cause aneurysms, a serious complication that can occur anywhere in your body. An aneurysm is a bulge in the wall of your artery. Most people with aneurysms have no symptoms. Pain and throbbing in the area of an aneurysm may occur and is a medical emergency. If an aneurysm bursts, you may face life-threatening internal bleeding. Although this is usually a sudden, catastrophic event, a slow leak is possible. If a blood clot within an aneurysm dislodges, it may block an artery at some distant point.
- Chronic kidney disease. Atherosclerosis can cause the arteries leading to your kidneys to narrow, preventing oxygenated blood from reaching them. Over time, this can affect your kidney function, keeping waste from exiting your body.
Prevention
The same healthy lifestyle changes recommended to treat atherosclerosis also help prevent it. These include:
- Quitting smoking
- Eating healthy foods
- Exercising regularly
- Maintaining a healthy weight
Just remember to make changes one step at a time, and keep in mind what lifestyle changes are manageable for you in the long run.
TREATMENT-
Treatment involves changing your current lifestyle to decrease the amount of fat and cholesterol you consume. You may need to exercise more to improve the health of your heart and blood vessels.
Unless your atherosclerosis is severe, your doctor may recommend lifestyle changes as the first line of treatment. You may also need additional medical treatments, such as medications or surgery.
Medications
Medications can help prevent atherosclerosis from worsening.
Medications for treating atherosclerosis include:
- cholesterol-lowering medications, including statins and fibrates
- angiotensin-converting enzyme (ACE) inhibitors, which may help prevent narrowing of your arteries
- beta-blockers or calcium channel blockers to lower your blood pressure
- diuretics, or water pills, to help lower your blood pressure
- anticoagulants and antiplatelet drugs such as aspirin to prevent blood from clotting and clogging your arteries
Aspirin is particularly effective for people with a history of atherosclerotic cardiovascular disease (e.g., heart attack and stroke). An aspirin regimen can reduce your risk of having another health event.
If there’s no prior history of atherosclerotic cardiovascular disease, you should only use aspirin as a preventive medication if your risk of bleeding is low and your risk of atherosclerotic cardiovascular disease is high.
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Surgery
If symptoms are especially severe or if muscle or skin tissue are endangered, surgery may be necessary.
Possible surgeries for treating atherosclerosis include:
- bypass surgery, which involves using a vessel from somewhere else in your body or a synthetic tube to divert blood around your blocked or narrowed artery
- thrombolytic therapy, which involves dissolving a blood clot by injecting a drug into your affected artery
- angioplasty, which involves using a catheter and a balloon to expand your artery, sometimes inserting a stent to leave the artery open
- endarterectomy, which involves surgically removing fatty deposits from your artery
- atherectomy, which involves removing plaque from your arteries by using a catheter with a sharp blade at one end
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