Atherosclerosis

  • Artherosclerosis of the blood vessels

Atherosclerosis is a disease affecting blood vessels and means literally "hardening of the arteries", with large and medium sized arteries most commonly affected.

What is Atherosclerosis?

Atherosclerosis occurs when the inside wall of the artery becomes furred up with deposits of cholesterol and calcium causing the blood vessel to become narrowed or blocked. These deposits are called 'atherosclerotic plaque'.

Atherosclerosis is what is known as a 'multifocal condition' meaning that it can occur in multiple parts of the body. For example, a patient with hardening of the arteries developing in one area of the body (such as the heart) is highly likely to have the same condition present in arteries elsewhere in the body. For this reason, someone who has a heart attack due to atherosclerosis is at a higher risk of having a stroke due to the same underlying condition affecting the brain arteries.

What part of the body does it affect?

Atherosclerosis can cause problems in three ways:

 

1)   Restriction of blood flow

2)   Embolisation (a blood clot forms, breaks off and lodges downstream)

3)   Thrombosis (blood in the artery clots and blocks)

 

The consequence of atherosclerosis depends on which arteries are affected by the hardening process.

 

Atherosclerosis in the heart causes angina and heart attacks, the first sign of which is normally severe chest pain.  Atherosclerosis in the arteries supplying the brain can cause strokes.  Hardened arteries in the limbs cause pain on walking (intermittent claudication). 

What are the symptoms?

Atherosclerosis symptoms will differ depending on which artery is affected. For example, angina is a symptom of athersclerosis (or hardening of the arteries) in the heart and pain in the leg when walking is a symptom of atherosclerosis in the leg. Athersclerosis in the arteries of the neck can lead to stroke. 

What are the treatment options?

Surgical intervention is seen as the 'last resort' and changes to lifestyle are normally recommended as the best treatment option. 

 

Is the condition preventable? If so, how?

There are a number of genetic or fixed risk factors for atherosclerosis that cannot be avoided since no-one can alter their age, the population into which they were born or the age at which a parent had a heart attack or stroke.

 

Risk factors that can be changed

Factors such as smoking, hypertension, cholesterol and living a sedentary lifestyle can all put you at risk of hardening of the arteries and a combination of two of these factors more than doubles the risk. 

 

Smoking

The more someone smokes, the higher their risk of developing hardening of the arteries.  This fact is complicated by the oddity that some individuals may smoke heavily without obvious ill effects, whilst others are much more susceptible to artery damage after smoking even a few cigarettes.  Some people can get away with it, most can't. 

 

Hypertension or high blood pressure

The International Society of Hypertension now defines hypertension as 'systolic pressure over 140 mmHg and diastolic pressure over 90 mmHg'.  These levels are arbitrary since the risk of heart disease and stroke rises steadily across the whole range of blood pressure.  The effect of the entire population lowering their blood pressure by only 5mmHg through lifestyle changes would be dramatic, reducing nearly ¼ of heart attacks and 1/3 of strokes.  The lower the blood pressure, the lower the risk of atherosclerosis.

 

Cholesterol

Like hypertension, the definition of hypercholesterolaemia or high cholesterol is a bit arbitrary as the risk of vascular disease rises steadily across the whole range of blood cholesterol levels. Treating patients with arterial disease with statins provides protection against heart attack and stroke, even for patients with normal cholesterol levels, since statins stabilise atherosclerotic plaque. 

 

Exercise

Regular aerobic exercise confers considerable protection against heart attack.  Thirty minutes of moderate activity most days of the week is the current recommendation. 

 

Diabetes

Patients with diabetes are at greatly elevated risk of vascular disease.  Good diabetic control improves the prognosis.

 

Alcohol

Heavy drinkers tend to have higher blood pressure but those who consume modest quantities of alcohol on a regular basis have lower mortality rates than teetotallers.

What should I do next?

If you think you or someone close to you may be developing the symptoms of artherosclerosis, click above to explore possible treatment options or contact us for more information or to make an appointment. 

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