Atherosclerosis – Causes, Risk, Treatment, Diagnosis and Tests

Furring up of the walls of the arteries with cholesterol and other fatty substances that cause them to narrow is a serious condition called atherosclerosis.

What is Atherosclerosis?

When the arteries of the heart and brain are affected by atherosclerosis, many common symptoms and diseases develop. In the case of the heart, common symptoms are angina and palpitations, and diseases include coronary heart disease and heart attack. In the case of the brain, symptoms are dizziness, drop attacks and memory loss, and diseases include stroke and dementia. Seen like this, atherosclerosis is the common denominator of many important conditions and the explanation for many symptoms. Because of its importance I start with atherosclerosis in this section on the heart and circulation. If you understand atherosclerosis

If you understand atherosclerosis you’ll automatically understand a lot about heart (cardiovascular) disease and strokes (cerebrovascular disease). You’ll also become aware of how to lower your chances of getting it and much of the treatment and recommended changes in lifestyle will become obvious and logical.

I also feel a brief discussion of cholesterol is useful for understanding how your heart condition has come about and how you can manage it. Cholesterol has been demonized but not all of it is bad. Indeed, some cholesterol, namely high-density lipoproteins (HDL) , is positively good for you and actually protects against heart disease. Atherosclerosis is a disease that results in the arteries becoming narrowed. The condition can affect arteries in any area of the body and is a major cause of stroke, heart attack and poor circulation in the legs. Platelets (tiny blood cells responsible for clotting) may collect in clumps on the surface of the fatty deposits and form blood clots. A large clot may then completely block the artery.

Atherosclerosis becomes more common with age. However, it rarely causes symptoms until around 45—50 years. The female sex hormone oestrogen helps protect against the development of atherosclerosis. As a result, the incidence of atherosclerosis is much lower in women before they reach the menopause than in men. By the age of 60, however, the risk of women developing atherosclerosis has increased until it is equal to the risk for men. On the other hand, women who take hormone replacement therapy that contains oestrogen will continue to be protected.

Causes of Atherosclerosis

The risk of developing atherosclerosis is determined largely by two things: the level of the level of cholesterol in the bloodstream, which depends on dietary and genetic factors, and whether or not you have the tendency, partly enetic, for cholesterol to collect on the walls of the arteries.

Since cholesterol levels are closely linked with a diet high in fat, atherosclerosis is most common in Western countries where people eat a high-fat diet. In some conditions, such as diabetes mellitus, there is a high blood fat level regardless of diet. Some inherited disorders, such as inherited hyperlipidaemia, also cause a high blood fat level.

Factors that make atherosclerosis more likely are smoking, not exercising regularly, having high blood pressure and being overweight, especially if fat accumulates around the waist.

Risk Factors For Atherosclerosis

There are several proven risk factors for atherosclerosis and given that atherosclerosis precedes most heart disease, the risk factors for atherosclerosis apply to heart conditions such as angina, coronary heart disease and heart attacks. These are: family history of angina or heart attack

• smoking
• diabetes mellitus
• high blood cholesterol
• not taking exercise or being overweight
• high blood pressure.

A healthy diet and lifestyle can slow the development of atherosclerosis in most people. If you do have a heart attack or a stroke, you can reduce the risk of having further complications by taking preventive measures.

Symptoms of Atherosclerosis

There are usually no symptoms in the early stages of atherosclerosis. If the coronary arteries that supply the heart muscle become blocked, however, symptoms include the chest pain of angina. If atherosclerosis affects the arteries in the legs, the first symptom may be cramping pain when walking caused by poor blood flow to the leg muscles.

Diagnoses of Atherosclerosis

Since atherosclerosis has no symptoms until blood flow has been restricted, it’s important to screen for it, checking on blood cholesterol levels, blood pressure and diabetes mellitus. You should have your cholesterol levels measured
at intervals of five years after the age of 20, if you are at risk .

We have sophisticated imaging techniques using X-rays (angiography) and ultrasound (Doppler scanning) that show up the blood flow in the blood vessels of the heart, brain and lungs. An electrocardiogram (ECG) will monitor the electrical activity of the heart. Some of these tests may be done as you exercise to check how your heart functions when it’s put under stress.

Treatment of Atherosclerosis

• Preventive measures include following a healthy lifestyle by eating a low-fat diet, not smoking, exercising regularly, and maintaining the recommended weight for your height.
• If you are in a good state of health but have been found to have a high blood cholesterol level, your doctor will advise a low-fat diet.
• You may also be offered drugs that decrease your blood cholesterol level. For people who have had a heart attack, research has shown that there is a benefit in lowering blood cholesterol levels, even if the cholesterol level is within the average range for healthy people.
• Your doctor may prescribe a drug such as low-dose aspirin to reduce the risk of clots forming on the damaged artery lining.
• If you are thought to be at a high risk of severe complications, your doctor may recommend other treatment, such as coronary angioplasty, in which a balloon is inflated inside the artery to widen it and improve blood flow.
• If blood flow to the heart is seriously obstructed, you may have coronary bypass surgery to restore blood flow.