What is Atherosclerosis?
Atherosclerosis is a condition characterised by a hardening of the arteries. It is a disease where a buildup of plaque in the arteries leads to a narrowing of the arteries, these are the blood vessels that carry oxygen and nutrients from the heart to the rest of the body.
As you get older, fat and cholesterol 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 and 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. Atherosclerosis can lead to heart attack, stroke, or heart failure if left untreated.
Atherosclerosis is a fairly common problem associated with aging. This condition can be prevented, and many successful treatment options exist.
Types of Atherosclerosis
Atherosclerosis occurs when fat, cholesterol, and calcium harden in your arteries. Atherosclerosis can occur in an artery located anywhere in your body, including your heart, legs, and kidneys.
Atherosclerosis can cause the following diseases:
Coronary Artery Disease
Coronary artery disease occurs when the coronary arteries of your heart become hard. The coronary arteries are blood vessels that provide your heart’s muscle tissue with oxygen and blood. Plaque prevents blood flow to the heart.
Carotid Artery Disease
The carotid arteries are found in your neck and supply blood to your brain. These arteries may be compromised if plaque builds up in their walls. The lack of circulation may reduce how much blood and oxygen reaches your brain’s tissue and cells.
Peripheral Artery Disease
Your legs, arms, and lower body depend on your arteries to supply blood and oxygen to their tissues. Hardened arteries can cause circulation problems in these areas of the body.
The renal arteries supply blood to your kidneys. Kidneys filter waste products and extra water from your blood. Atherosclerosis of these arteries may lead to kidney failure.
Causes of Atherosclerosis
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:
Cholesterol is a waxy, yellow substance that’s found naturally in your body and also in certain foods you eat. If the levels of this substance 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.
It’s important to eat a healthy diet.
- Avoid foods with added sugar, such as sugar-sweetened beverages, candy, and desserts. The American Heart Association 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 eat no more than 2,400 milligrams of sodium per day.
- Avoid foods high in fat; replace them with the better fats, monounsaturated and polyunsaturated. 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.
- The American Heart Association recommends you eat an overall healthy dietary pattern that emphasizes:
- a variety of fruits and vegetables
- whole grains
- low-fat dairy products
- skinless poultry and fish
- nuts and legumes
- non-tropical vegetable oils
- Eating foods high in fat may also lead to plaque buildup.
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.
Risk Factors for Atherosclerosis
Many factors place you at risk for atherosclerosis. Some risks can be prevented, while others cannot.
If atherosclerosis runs in your family, you may be at risk for hardening of the arteries. This condition as well as other heart-related problems may be inherited.
Lack of Exercise
Regular exercise is good for your heart. It keeps your heart muscle strong and encourages oxygen and blood flow throughout your body. Living a sedentary lifestyle increases your risk for a host of medical conditions, including heart disease.
High Blood Pressure
High blood pressure can damage your blood vessels by making them weak in some areas. Cholesterol and other substances in your blood may reduce the flexibility of your arteries over time.
Smoking tobacco products can damage your blood vessels and heart.
People with diabetes have a much higher incidence of coronary artery disease.
Symptoms of Atherosclerosis
Most symptoms of atherosclerosis don’t show until a blockage occurs. Common symptoms include:
- chest pain or angina
- pain in your leg, arm, and anywhere else that has a blocked artery
- shortness of breath
- confusion, which occurs if the blockage affects circulation to your brain
- muscle weakness in your legs from lack of circulation
It’s also important to know the symptoms of heart attack and stroke. Both of these problems can be caused by atherosclerosis and require immediate medical attention. The symptoms of a heart attack include:
- chest pain or discomfort
- pain in the shoulders, back, neck, arms, and jaw
- abdominal pain
- shortness of breath
- nausea or vomiting
- a sense of impending doom
The symptoms of stroke include:
- weakness or numbness in the face or limbs
- trouble speaking
- trouble understanding speech
- vision problems
- loss of balance
- sudden, severe headache
Call 911 and get to a hospital’s emergency room as soon as possible if you experience symptoms of a heart attack or stroke.
Diagnosis of Atherosclerosis
Your doctor will perform a physical exam 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 of the arterial wall
- slow wound healing, which indicates a restricted blood flow
A heart specialist called 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. These 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
- ankle-brachial index test, which looks for a blockage in your arms or legs by comparing the blood pressure in each limb
- magnetic resonance angiography (MRA) or computed tomography angiography (CTA) to create pictures of the large arteries in your body
- cardiac angiogram, which requires an injection of a radioactive dye that can be seen on X-rays to create a picture of the arteries in your heart
- an electrocardiogram (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
Treatment of Atherosclerosis
Treatment involves changing your current lifestyle to one that limits the amount of fat and cholesterol you consume. You may need to exercise more to improve the health of your heart and blood vessels.
You may also need additional medical treatments, such as:
Medications can help prevent atherosclerosis from worsening. Medications include:
- cholesterol-lowering medications, including statins and fibric acid derivatives
- antiplatelet drugs and anticoagulants, such as aspirin, to prevent blood from clotting and clogging your arteries
- beta blockers or calcium channel blockers to lower your blood pressure
- diuretics, or water pills, to help lower your blood pressure
- angiotensin converting enzyme (ACE) inhibitors, which help prevent narrowing of your arteries
In some cases, surgery may be necessary if symptoms are especially severe, or if muscle or skin tissue are endangered. 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 thin, flexible tube called 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
Outlook for Atherosclerosis
With treatment, you may see improvement in your health, but this may take time. The success of your treatment will depend on the severity of your condition, how promptly it was treated, and whether other organs were affected. Hardening of the arteries cannot be reversed, but treating the underlying cause and making healthy lifestyle and dietary changes can help slow down the process or prevent it from getting worse.
You should work closely with your doctor to make the appropriate lifestyle changes. You’ll also need to take the proper medications to control your condition and avoid complications. The complications of atherosclerosis include:
- heart failure
- heart disease
- heart attack
- abnormal heart rhythm
- peripheral artery disease, which reduces blood flow to your arms and legs
- kidney failure
Prevention of Atherosclerosis
Lifestyle changes can help to prevent as well as treat atherosclerosis. Unless your atherosclerosis is severe, your doctor may recommend lifestyle changes as the first line of treatment. Lifestyle changes include:
- eating a healthy diet that’s low in saturated fat and cholesterol
- avoiding fatty foods
- adding fish to your diet twice per week
- exercising for 30 to 60 minutes per day, six days per week
- quitting smoking if you’re a smoker
- losing weight if you’re overweight or obese
- managing stress
- treating conditions associated with atherosclerosis, such as hypertension, high cholesterol, and diabetes