Atherosclerosis
Everyone has atherosclerosis to some degree... it has been found in autopsies of 3 year old children, healthy soldiers and athletes that have died in accidents. It is not only a disease of old age or unhealthy lifestyle. Atherosclerosis shows no symptoms until the damage to the arteries is severe enough to restrict blood flow.
Atherosclerosis is basically thickening of the artery walls due to plaque (raised patches) build-up, it's danger is that the narrowed channel may be blocked (by say a clot of blood) leading to reduced/stopped blood flow to subsequent areas. It is most dangerous when it occurs in the heart (angina or cardiovascular accident) or brain (transient ischemic attacks or stroke) or lungs (pulmonary embolism) or arteries leading to them, but can occur in any area of the body eg kidneys and legs (claudication).
These plaques consist of LDLs, fibrous tissue, clumps of blood platelets, cholesterol, and sometimes calcium. They tend to form in regions of turbulent blood flow (like the heart) and increase in size and number with age. The plaques encourage blood clots to form, which can dislodge and travel. They are most prevalent in people with high concentrations of cholesterol.
Causes
Atherosclerosis "ties" together a number of diseases or conditions like: High Blood Pressure, High Cholesterol, Diabetes and Smoking.
As stated above atherosclerosis may begin as early as childhood, and develops slowly. Although the exact cause is unknown, it may start with damage or injury to the artery. The damage may caused by high blood pressure, high cholesterol, smoking, and diabetes.
After the artery is damaged, platelets form at the damaged site to repair the artery. Then fatty deposits (plaques) made of cholesterol and other cellular waste products as above accumulate, and then harden.
Who's at risk
Everyone !If you have diabetes, then atherosclerosis (and cholesterol levels) must be taken seriously.
If you think of a pyramid, there is a tip at the top where you know someone has very bad atherosclerosis because they have just had a vascular incident (heart attack, stroke), at the bottom there is group of people with very low risk (young, healthy lifestyle). In between there is a large group of medium to high risk patients that are walking "time-bombs".
Risk factors for atherosclerosis include:
- Smoking
- Diabetes
- Obesity
- High blood cholesterol
- High-fat diet
- High blood pressure
- Cerebrovascular disease
- Peripheral vascular disease
- Ethnicity
- History of heart disease
- Family history of heart disease
Treatment
Keeping a healthy lifestyle will help your arteries - like quitting smoking - smoking makes the blood thicker as well as contributing to plaque build-up. Eat healthy low-fat foods which lowers LDL, and having regular physical activity which increases HDL (the "good" cholesterol which mops up LDL from the artery walls).
Medications include Cholesterol lowering medications like statins. Anti-platelet medications like low dose aspirin, to reduce the likelihood that platelets will clump in narrowed arteries, form a blood clot and cause further blockage. Anticoagulants like warfarin which help to prevent clots forming. Blood pressure medications can help slow the progression of atherosclerosis.
In extreme cases surgery may be required such as Angioplasty in which an inflated balloon is passed through the affected artery compressing the deposits against your artery walls. A stent (like a tube) may be left in the artery to help keep the artery open. In other cases fatty deposits may be surgically removed from the walls of a narrowed artery. Also a clot-dissolving drug can be injected directly into the artery at the point of the clot to break it up. Finally bypass surgery where a graft bypass using a vessel from another part of your body (eg leg) allows blood to flow around the blocked or narrowed artery.
The Future
We are at the stage where we can scan the body's arteries to check to see how bad the atherosclerosis is, eg CT scan, Magnetic resonance scans, or intravascular ultrasounds. Maybe one day it may become routine like a cholesterol or blood pressure check.
There are many genes involved in atherosclerosis which scientists can identify, so that in the future gene therapy may provide new treatments or prevention for atherosclerosis.
Related external Links
From Birmingham University school of medicine.
The information given here is of a general nature, for particular information talk to your pharmacist or doctor, especially if you have any other diseases, are taking other medicines, suffer other conditions or pregnant etc.
