Atherosclerosis is a disease that affects the blood vessels called arteries, which carry blood to the organs of the body. Normal arteries allow blood to flow freely. However, these arteries can become hardened and narrowed by deposits called plaques. These plaques are made up of cholesterol and inflammatory materials. This disease process is called atherosclerosis and it can occur in any artery in your body. Atherosclerotic plaques build up over time and can decrease the amount of blood flow to the area the artery supplies. Check out a DoveMed selected video on athersclerosis.
What are the other Names for this Condition? (Also known as/Synonyms)
- Arterial Degeneration
- Hardening of the Arteries
What is Atherosclerosis? (Definition/Background Information)
- Blood pumped from the heart travels through the arteries, carrying oxygen and nutrients, to reach various parts of the body, like the vital organs, head, limbs, etc.
- In Atherosclerosis, sometimes due to various lifestyle and/or genetic factors, the arteries become hard and clogged with a wax-like substance, composed of fat and other materials, called plaque
- This buildup of plaque, which can occur in any artery, obstructs the free flow of blood to various body regions, leading to major medical complications, including death
- The disease develops slowly over time, usually with an advancing age. The management of Atherosclerosis requires both active and passive treatment measures, such as surgery, medications, and modification to lifestyle
Who gets Atherosclerosis? (Age and Sex Distribution)
- The incidence of Atherosclerosis (a very common health issue) increases with age, due to genetic/lifestyle -related plaque buildup in the arteries. The condition may start during early teenage but, children are unaffected by Atherosclerosis
- Manifestation of this vascular condition becomes evident after the age of 50 years
- There is no gender preference (both males and females are affected)
- No racial or ethnic predilection is observed
What are the Risk Factors for Atherosclerosis? (Predisposing Factors)
Potential risk factors for Atherosclerosis are the following:
- A diet high in fat, cholesterol, sugar, and salt, can cause unhealthy body conditions. This could result in obesity, high fat (triglyceride) levels, low ‘good’ cholesterol (HDL) and high ‘bad’ cholesterol (LDL) levels
- High blood pressure, severe mental/emotional stress
- Advancing age causing arterial wall thickening, hardening
- Smoking tobacco: It contributes significantly to the risk factors by creating cholesterol level imbalance, limits oxygen supply, constricts/injures blood vessels, thus causing elevated blood pressure levels
- Diabetes (this can quadruple the risk), high sugar levels, and insulin resistance due to body’s inability to use insulin effectively
- Leading a sedentary life, lacking physical activities or exercises
- Certain diseases and disorders may cause narrow carotids (arteries, located both sides of the neck), such as connective tissue disorders (like Marfan syndrome), fibromuscular dysplasia
- Family medical history of Atherosclerosis, stroke, other coronary heart diseases
Most times, multiple risk factors are observed in an individual, thereby tending to create a greater impact.
It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.
Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.
What are the Causes of Atherosclerosis? (Etiology)
- Generally, the arteries are smooth and resilient, permitting easy passage of blood. However, with time they lose some flexibility, become rigid, and get constricted, due to plaque deposits along the walls, a condition termed as Atherosclerosis
- The plaque, consisting of microscopic fat particles, cholesterol, calcium, and cell debris, reduce the effective flow diameter of the artery, leading to decreased blood volume flow
- Moreover, tiny amounts of blood that may accumulate at these deposits harden and clot. There is a possibility that these blood clots might be carried by blood, to several different body regions/organs, causing additional health issues, stoppage of blood flow to some parts, etc.
- There are many factors that aid in plaque formation and they include:
- Food (high in salt, oil, sugar)
- High blood pressure
- Smoking tobacco
- Sedentary life
- Alcohol consumption
- Old age
- Familial factors
- Other disorders
What are the Signs and Symptoms of Atherosclerosis?
Mild Atherosclerosis can present itself without any sign or symptom, for a long period. There is a possibility that it might suddenly develop into a life-threatening situation.
- Signs and symptoms are dependent upon the arterial location of plaque buildup, and the organs and parts to which blood supply is reduced, or even stopped
- The most common problem is coronary heart disease (heart attack, angina), if plaque deposit forms on the coronary artery
- If the carotid artery is affected, then it could cause carotid artery disease leading to a stroke, as blood supply to the brain is affected
- Chronic renal disease occurs, when the renal artery that supplies blood to the kidneys are compromised, due to plaque formation
- When the upper/lower limbs, or pelvic region is affected; it results in peripheral arterial disease
How is Atherosclerosis Diagnosed?
Diagnostic tests for Atherosclerosis include:
- Physical exam with evaluation of medical history; listening to the heart/lung artery (in the neck) using a stethoscope, to detect any unusual ‘whooshing’ sound
- Exercise stress test
- Blood tests to determine blood sugar, cholesterol, triglycerides (a type of fat) levels
- Doppler ultrasound (or sonography) scan: To test blood flow, pressure values, and if any obstruction is present in the artery
- By injecting a special dye into the blood vessels and studying x-ray images through a technique, called angiography or arteriogram
- Other imaging studies used include CT Angiography, or MR Angiography
Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.
What are the possible Complications of Atherosclerosis?
Complications due to Atherosclerosis include:
- Infrequently, blood clots may develop, or bits of plaque may become dislodged from the arterial wall, which may obstruct blood flow, or travel to other vital organs (brain, lungs, or heart)
- The paste-like plaque on the arterial wall can cause a structural weakening of the walls, due to which a balloon-like bulge may occur (called aneurysm). This may cause internal bleeding (if it ruptures) with fatal results, based on its location
How is Atherosclerosis Treated?
Treatment of Atherosclerosis is based on the location of the plaque, the medical emergency it has created (if any), the overall health condition of the individual, and the signs and symptoms present.
The general steps that a physician may consider to manage the condition are:
- Advocate changes to lifestyle:
- Avoid smoking, consumption of tobacco products
- Limit alcohol consumption
- Exercise on a regular basis
- Have a healthy diet, avoid high-fat/salt diets
- Manage stress
- Use of medications, in order to:
- Lower blood pressure (calcium channel blockers, beta blockers, water pills)
- Prevent blood clots (anti-platelet drugs)
- Limit the progression of plaque buildup (ace inhibitors)
- Lower cholesterol levels (statins, fibrates)
- Surgical procedures are also used to help treat Atherosclerosis. These include: Artery bypass grafting (major invasive technique), angioplasty, placing stents to expand arteries, thrombolytic therapy (to dissolve a blood clot), etc.
How can Atherosclerosis be Prevented?
Atherosclerosis may not be preventable. However, some of the risk factors that lead to the condition should be controlled, in order to reduce the progress rate of plaque-development, and the occurrence of serious complications.
- Smoking has to be completely avoided, self-impose alcohol limit to a minimum
- Individuals have to minimize their stress, and always maintain blood pressure in control and within acceptable levels
- A healthy diet, rich in fruits, vegetables, fish, whole grains, and low in fats, sugar, delays any buildup of plaque
- Be aware of signs and symptoms of Atherosclerosis-related diseases, particularly if you are over 50 years of age
- Have periodic medical health check-ups, more so if the risk factors are applicable to you
- Maintain a healthy weight, exercise regularly, and be physically active
What is the Prognosis of Atherosclerosis? (Outcomes/Resolutions)
- Atherosclerosis may remain asymptomatic and may not be noticed until a medical complication develops. In such situations, the prognosis is dependent on several factors
- An advancing age and genetic parameters cannot be changed, but modifications to lifestyle may keep the condition from progressing to a life-threatening illness
Additional and Relevant Useful Information for Atherosclerosis:
A healthy lifestyle can help improve the quality of the arteries. Light exercising (walking, swimming, as recommended by the physician), periodic health check-ups, keeping blood pressure under control, avoiding smoking and alcohol, and taking a healthy food (less in sugar, salt, and fats), all are good and beneficial practices.
What are some Useful Resources for Additional Information?
References and Information Sources used for the Article:
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001224/ (accessed on 1/6/13)
http://www.nhlbi.nih.gov/health/health-topics/topics/atherosclerosis/ (accessed on 1/6/13)
http://www.mayoclinic.com/health/arteriosclerosis-atherosclerosis/DS00525 (accessed on 1/6/13)
http://www.heart.org/HEARTORG/Conditions/Cholesterol/WhyCholesterolMatters/Atherosclerosis_UCM_305564_Article.jsp (accessed on 1/6/13)
Helpful Peer-Reviewed Medical Articles:
Jiang, X. C., & Liu, J. (2013). Sphingolipid metabolism and atherosclerosis.[Review].HandbExpPharmacol(216), 133-146. doi: 10.1007/978-3-7091-1511-4_7
Maksimova, M., Korobkova, D. Z., &Krotenkova, M. V. (2012). [Diagnostic methods for cerebral artery atherosclerosis in clinical practice].[Review].VestnRentgenolRadiol(6), 35-41.
Pasterkamp, G. (2013). Methods of accelerated atherosclerosis in diabetic patients.[Review].Heart, 99(10), 743-749. doi: 10.1136/heartjnl-2011-301172
Ruan, C. X., Li, Y. J., Yang, Q., Chen, Y., Weng, X. G., Wang, L., . . . Zhu, X. X. (2013). [Effect of adventitia cells on occurrence and development of atherosclerosis].[Review].ZhongguoZhong Yao ZaZhi, 38(6), 791-794.
Titov, V. N., Khokhlova, N. V., &ShiriaevaIu, K. (2013). [Glucose, glycotoxins, and protein glycation products: the role in pathogensis]. [Review].Klin Med (Mosk), 91(3), 15-24.
Woollard, K. J. (2013). Immunological aspects of atherosclerosis. [Research Support, Non-U.S. Gov't Review]. ClinSci (Lond), 125(5), 221-235. doi: 10.1042/CS20120576
Blankenberg, S., Barbaux, S., & Tiret, L. (2003). Adhesion molecules and atherosclerosis. Atherosclerosis, 170(2), 191-203.
Beltowski, J. (2006). Leptin and atherosclerosis. Atherosclerosis, 189(1), 47-60.