Atherosclerosis, also known as arteriosclerosis is a narrowing and hardening of the arteries caused by a buildup of plaque. The arteries are blood vessels that carry oxygen and nutrients from the heart to the rest of the body.
Fat and cholesterol can collect in your arteries and form plaque as you grow older. It becomes difficult for blood to flow through your arteries as plaque builds up in your arteries. It may occur in any artery including your heart, legs, and kidneys. It can result in a shortage of blood and oxygen. Blood clots may also develop as pieces of plaque can break off.
This condition can lead to heart attack, stroke and heart failure if left untreated.This condition is a fairly common problem associated with aging. The good news is that this condition can be prevented and there are many successful treatment options.
What Causes Atherosclerosis?
The following are common causes of hardening of the arteries:
- High Cholesterol: A waxy, yellow substance known as cholesterol can be found naturally in your body and in certain food you consume. It can increase in your blood and clog up your arteries. It becomes a hard plaque that restricts or blocks blood circulation to your heart and other organs.
- Fat: Consuming food high in fat may also lead to plaque buildup
- Aging: Your heart and blood vessels work harder to pump and receive blood as you age. Your arteries become more susceptible to plaque buildup as they may weaken and become less elastic.
Who Is at Risk for Atherosclerosis?
There are many factors that can place you at risk. While some risks can be prevented, others can’t be prevented.
- Family History: You may be at risk if you have a family history of this condition as it may be inherited.
- Lack of Exercise: Getting regular exercise is good for your heart as it keeps your heart muscle strong and encourages oxygen and blood flow throughout your body. A sedentary lifestyle can increase your risk.
- Diet: Consuming food high in fats and cholesterol increases your risk.
- High Blood Pressure: Damage to your blood vessels may occur as high blood pressure makes them weak in some areas. Cholesterol and other substances may reduce the flexibility of your arteries over time.
- Smoking: Tobacco products can damage your blood vessels and heart.
- Diabetes: Diabetic people have a higher incidence of coronary artery disease.
This condition develops gradually. Mild atherosclerosis doesn’t normally 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: Symptoms such as chest pain or pressure (angina).
- 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, temporary loss of vision in one eye or drooping muscles in your face. These symptoms signal a transient ischemic attack (TIA) and if it’s left untreated, may progress to a stroke.
- If you have atherosclerosis in the arteries in your arms and legs: May experience symptoms of peripheral artery disease such as leg pain when walking (claudication).
- If you have atherosclerosis in the arteries leading to your kidneys: May develop high blood pressure or kidney failure.
Lifestyle changes like eating healthy and exercising are often the most appropriate treatment for atherosclerosis. Medication or surgical procedures may sometimes be recommended as well.
Various drugs are available to slow down or even reverse the effects of atherosclerosis. Some of the common choices include:
- Cholesterol medications: Aggressively lowers your low-density lipoprotein (LDL) cholesterol (bad cholesterol) so that it slows down, stop or even reverse the buildup plaque. Increasing your high-density lipoprotein (HDL) cholesterol, (good cholesterol) may help too. A range of cholesterol medications including drugs known as statins and fibrates may be chosen by your doctor. Statins have additional effects that can help to stabilize the lining of your heart arteries and prevent atherosclerosis.
- Anti-platelet medications: Anti-platelet medications such as aspirin may be prescribed. Aspirin reduces the likelihood that platelets will clump together in narrowed arteries to form a blood clot and cause further blockage.
- Beta blocker medications: Commonly used for coronary artery disease, they lower your heart rate and blood pressure. This reduces the demand on your heart and can often relieve symptoms of chest pain. The risk of heart attacks and some heart rhythm problems are reduced.
- Angiotensin-converting enzyme (ACE) inhibitors: The progression of atherosclerosis is slowed down when blood pressure is lowered. ACE inhibitors also produces other beneficial effects on the heart arteries. It can also reduce the risk of recurrent heart attacks.
- Calcium channel blockers: Blood pressure is lowered using this treatment and are sometimes used to treat angina.
- Water pills (diuretics): High blood pressure is a major risk factor. Diuretics is used to lower blood pressure.
- Other medications: Certain medications may be used to control specific risk factors for atherosclerosis such as diabetes. Specific medications may sometimes be used to treat symptoms of atherosclerosis such as leg pain during exercise.
More aggressive treatment is sometimes needed to treat atherosclerosis. You may be a candidate surgical procedures if you have severe symptoms or a blockage that threatens the muscle or skin tissue survival. These surgical procedures include:
- Angioplasty and stent placement: A long, thin tube (catheter) is inserted into the blocked or narrowed part of your artery. A second catheter with a deflated balloon on its tip is passed through the catheter to affected area. The balloon is inflated and it compresses the deposits against your artery walls. A stent is normally left in the artery to help keep the artery open.
- Endarterectomy: Fatty deposits must be surgically removed from the walls of a narrowed artery in some cases. It’s called a carotid endarterectomy when the procedure is done on arteries in the neck (the carotid arteries).
- Fibrinolytic therapy: A clot-dissolving drug may be used to break a clot if you have an artery that’s blocked by a blood clot.
- Bypass surgery: A graft bypass may be created using a vessel from another part of your body or a tube made of synthetic fabric. This enables blood to flow around the blocked or narrowed artery.
- History taking & Physical exam: Questions regarding symptoms will be asked. A physical exam may also be performed if you have symptoms of atherosclerosis. They’ll check for a weakened pulse, an aneurysm (which is an abnormal bulging or widening of an artery due to weakness) and slow wound healing (indicates a restricted blood flow)
- Blood tests: To detect increased levels of cholesterol and blood sugar that may increase the risk. Fasting will be required for 9 to 12 hours before your blood test. Your doctor should tell you ahead of time if this test will be conducted during your visit.
- Doppler ultrasound: A special ultrasound device will be used to measure your blood pressure at various points along your arm or leg. This will help your doctor gauge the degree of any blockages and the speed of blood flow in your arteries.
- Ankle-brachial index: This test tell if you have hardened arteries in your legs and feet. Blood pressure in your ankle with the blood pressure in your arm may be compared. An abnormal difference may indicate peripheral vascular disease which is usually caused by atherosclerosis.
- Electrocardiogram (ECG): Electrical signals are recorded as they travel through your heart. It can often reveal evidence of a previous heart attack. Your doctor may ask you to walk on a treadmill or ride a stationary bike during an ECG if your signs and symptoms occur most during exercise.
- Stress test: Also called an exercise stress test, it is used to gather information about how well your heart works during physical activity. As exercise makes your heart pump harder and faster than it does during most daily activities, a stress test can reveal problems within your heart that might not be noticeable otherwise.A stress test normally involves walking on a treadmill or riding a stationary bike while your heart rhythm, blood pressure and breathing are monitored. Pictures will be taken of your heart such as during a stress echocardiogram (ultrasound) or nuclear stress test in some stress tests. You may receive a medication that mimics the effect of exercise on your heart if you’re unable to exercise.
- Cardiac catheterization and angiogram: Your coronary arteries will be shown if they are narrowed or blocked. A liquid dye is injected into the arteries of your heart through a long, thin tube (catheter) fed through an artery usually in your leg to the arteries in your heart. As the dye fills out your arteries, they become visible on X-ray revealing areas of blockage.
- Other imaging tests: The ultrasound, computerized tomography (CT) scan or magnetic resonance angiography (MRA) may be used to study your arteries. They can often show hardening and narrowing of large arteries as well as aneurysms and calcium deposits in the artery walls.