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Information about Atherosclerosis

What is Atherosclerosis?

Atherosclerosis, also known as arteriosclerosis, is a common disorder of the arteries characterised by the build up of plaque - cholesterol, fatty substances and calcium - on the inside (endothelial surface) of medium and large-sized arteries. This results in the narrowing and hardening of arteries, which in turn leads to reduced blood flow, a higher risk of blood clots, organ damage and premature death.

Atherosclerosis develops gradually; it often starts in childhood and advances as we get older if we are at risk for the disease. (See risk factors below). If left untreated, atherosclerosis is a major risk factor for cardiovascular disease - the leading cause of death in the UK.

Why atherosclerosis develops is still being debated; however, many scientists agree that inflammation and oxidative stress play a decisive role.

What are the symptoms of atherosclerosis?

Atherosclerosis typically has no symptoms until an artery is severly narrowed or blocked causing a blood clot, heart attack or stroke. When symptoms do appear, they depend on which arteries are affected.

Atherosclerosis in the coronary (heart) arteries
If blood flow to the heart is restricted or blocked, a heart attack can ensue. Symptoms include:

Chest pain (angina pectoris).
Shortness of breath.
Dizziness.
Sweaty, grey complexion.
Nausea and vomiting.
Coughing.

Atherosclerosis in the arteries of the arms and legs
This is called peripheral arterial disease (PAD) and most often affects the legs. Symptoms include:

Muscle pain or cramping in the legs or arms during activity, such as walking (intermittent claudication).
Numbness and weakness in the legs.
Sores on feet or legs that don't heal.
Coldness in one lower leg or foot compared to the other.
Change in skin colour of the legs.
Hair loss on legs and feet.
Thicker toenails.

Atherosclerosis in the arteries of the brain
The arteries leading to the brain are called the carotid arteries and blockage could result in a stroke. Symptoms include:

Sudden numbness and weakness in the arms and legs. This often happens on one side of the body and could be as severe as total paralysis of one side of the body.
Difficulty speaking and understanding other speak.
Drooping face muscles.
Dizziness.
Difficulty with balance and coordination.
Difficulty swallowing.
Severe headaches.

What causes Atherosclerosis?

Many scientists believe that inflammation and oxidative stress are major contributors to the development of atherosclerosis. Inflammation and oxidative stress are a consequence of damage to the body, in this case of damage to the inner lining of arteries. Inflammation is the body's way of trying to heal itself and in doing so allows platelets (blood cells that aid in blood clotting) to aggregate in the damaged portions of the arteries. Eventually, plaque also deposits in the site of injury resulting in narrowing and hardening of the artery. The problem is when damage causes continuous (chronic) inflammation. Many things can cause this including:

High LDL (unhealthy cholesterol and triglyceride blood levels.
High blood pressure.
Tobacco smoke.
Diabetes.
Stress.
Excessive alcohol consumption.

Atherosclerosis risk factors

Some people have a higher risk of developing atherosclerosis than others; some of these factors can be controlled, others cannot.

High LDL (unhealthy) cholesterol levels and low HDL (healthy) cholesterol levels.
High blood pressure.
Smoking.
Age: for men the risk increases from age 45 and for women from age 55.
Obesity.
Lack of physical activity.
Insulin resistance or diabetes.
Family history of early heart disease or aneurysms.
Elevated levels of C-reactive protein (CRP) in the blood. CRP is an inflammation marker and research shows that high levels place people at a higher risk for atherosclerosis and cardiovascular disease.

How is atherosclerosis diagnosed?

Physical exam: Evidence of atherosclerosis can be found by looking for a weak or absent pulse in an artery, decreased blood pressure in a limb and bruits (abnormal whooshing sounds) over arteries.
Blood tests: To check cholesterol, triglyceride, sugar and protein levels in the blood.
Ankle-brachial index: By comparing the blood pressure in the ankle and your arm, blood flow can be assessed.
Electrocardiogram (ECG): Assesses the function of the heart. It often can show if a heart attack was previously suffered.
Doppler ultrasound: Measures blood pressure at specific points along the limbs.
Angiogram (arteriograph): A dye is injected into the arteries to show blood flow and any blockages.
Computer tomography (CT) scan: A CT scan can often reveal narrowing and hardening or arteries as well as calcium deposits and aneurysms.

How is atherosclerosis treated?

Atherosclerosis can often be treated and prevented by lifestyle changes. Read more about natural ways of treating an preventing atherosclerosis.

Conventional Atherosclerosis Treatments

If allergens have been identified, avoiding them is vital; however, some types of allergies, such as hay fever, may be impossible to avoid altogether. The following are some conventional allergy treatments:

Statins: These are cholesterol-lowering medications that inhibit an enzyme in the liver that produced cholesterol. Statins, however, have many unpleasant side effects including: cancer; weakness; muscle aches; immune system supression; liver failure; rhabdomyolysis (a serious degenerative muscle tissue condition); memory loss; and heart disease.
Anticoagulants: Blood thinners, such as heparin and warfarin are prescribed to thin the blood and prevent blood clots. These also have many adverse side effect including: haemorrhage; hypotension; dizziness; headache; stroke; coma; rash; liver damage; joint and muscle pain; and osteoporosis.
Anti-platelet medications: These, such as aspirin, reduce platelet aggregation and blood clot formation. Side effects include: haemorrhage; hypotension; tachycardia; dizziness; headache; confusion; gastric ulcers; nausea; vomiting; kidney and liver damage; and asthma. In children under the age of 16, aspirin is associated with Reye's syndrome, a rare but life-threatening condition.
Blood pressure medications: These include beta blockers, calcium channel blockers and angiotensin-converting enzyme (ACE) inhibitors intended to lower blood pressure and widen blood vessels. Side effects include: chest pain; fatigue; insomnia; upper respiratory infection; rhinitis and sinusitis.

In severe cases of artery blockage, certain procedures may be conducted:

Angioplasty: A long thin tube is inserted in an artery into which a balloon is inserted and inflated to open up the blood vessel. Often a stent (tube) is left in the artery to help keep it open.
Endarterectomy: A surgical incision is made to open an artery and remove fatty deposits causing blockage.
Bypass surgery: This involves inserting a tube or taking part of an artery from another part of the body to allow blood flow around the blocked artery.

References:

Atherosclerosis Supplements