Atherosclerosis : Causes, Complications, and Prevention
Atherosclerosis occurs when arteries grow narrow and rigid as a result of plaque accumulating along the artery’s inner walls.
Cholesterol, fat, blood cells, and other components in the blood build plaque gradually along the inner walls of the major arteries, narrowing or clogging them. As a result, lesser amount of blood reaches the body’s vital organs.With time, the artery walls may stiffen because of fibrous connective tissue and calcium depositing in the lesion. The blood cells together with these plaques may end up forming blood clots and when dislodged into the bloodstream, may block the arteries and cause sudden restriction of blood flow resulting in heart attacks and strokes. Atherosclerosis can damage all arteries, including the aorta and coronary arteries. It is a common condition and a primary factor in around 50% of the deaths in westernized societies.
What are the symptoms ?
There may be no symptoms of mild atherosclerosis. According to the affected artery, the moderate to severe type may exhibit the following symptoms:
Coronary artery involvement may manifest as:
- An abnormal heartbeat, or arrhythmia.
- A chest ache or pressure.
- Chest, jaw, or arm pain.
- Breathing difficulties.
When the blockage happens in the arteries that supply blood to the brain:
- Sloppiness or difficulty speaking
- Having trouble understanding or making judgments.
- Short-term blindness in either one or both eyes;
- Facial muscles that droop.
- A terrible headache.
Involvement of arteries of the arms, legs, or pelvis, may show:
- Arms or legs tingling or feeling numb.
- Decreased blood pressure in an affected limb.
- Numbness of a leg or both.
Causes and risk factors
Although the exact reasons and associated risks of atherosclerosis are unknown, several conditions, characteristics, or behaviors may increase the probability of atherosclerosis developingas follows:
- Unhealthy blood cholesterol – High LDL and low HDL levels in the blood.
- Long-term high blood pressure – which is often above 140/90 mmHg.
- Smoking – Smoking reduces the amount of oxygen that reaches the body’s tissues while also having the potential to tighten and harm blood vessels.
- Having diabetes may increase the chances.
- Overweight – a person’s body weight above what is deemed typical for their height.
- A sedentary lifestyle – may make other atherosclerosis risk factors worse.
- A diet that is unhealthy – overindulgence in sugary, fried and fatty food.
- Growing older – the risk increases for women after age 55 and for men after age 45.
- Family history – When one or more family members have heart disease, the chance of having atherosclerosis is increased.
- Inflammation – this is the body’s response to any injury or damage, and it can promote plaque growth.
- Elevated levels of C-Reactive Protein (CRP) – may increase the rate of disease progression.
- Stress – the leading cause of heart attacks, according to reports.
- Alcohol – heavy drinkers run a higher risk of heart muscle injury.
- Sleep apnea – if left untreated.
By controlling the risk factors, the following steps can help avoid or delay plaque buildup:
- Quit the habit of smoking.
- Minimize or stop alcohol intake.
- Consume a nutritious diet that does not include foods that are high in sugar, salt, or saturated and trans fats.
- Keep your cholesterol levels under control.
- Engage in regular exercise.
- Maintain an appropriate weight for your height.
- Maintain a healthy blood pressure level by monitoring it regularly.
- Maintain healthy blood sugar levels.
- Manage stress effectively with yoga, mindfulness, breathing exercise, etc.
- Get treatment for insomnia or sleep apnea.
Diagnosis of Atherosclerosis
After asking about the patient’s symptoms, past medical history, and history of family members, the doctor may begin with a physical examination, then proceed to perform a few tests if necessary.
- Physical examination – performed to check blood pressure, listen for abnormal heartbeats, and listen for a whooshing sound in the neck.
- Blood tests – used to assess cholesterol, blood sugar levels and C-reactive protein (CRP) test.
- Electrocardiogram (ECG or EKG) – monitors the heart’s electrical activity, rhythm, and pace and can also reveal whether the heart is receiving less blood than usual.
- Exercise stress test – might detect heart issues that might otherwise go undetected since exercise causes the heart to beat faster and harder than it does during the majority of regular activities.
- Echocardiogram – employs sound waves to display the heart’s blood flow.
- Doppler ultrasound – used at various sites for measuring blood pressure and the rate of blood flow through arteries.
- Ankle-brachial index (ABI) – The disparity between the blood pressures in arms and legs could be related to a condition called peripheral vascular disease, triggered by atherosclerosis.
- Cardiac catheterization and angiogram – can demonstrate the presence of blocked or constricted coronary arteries.
- Coronary calcium scan – commonly known as a heart scan, produces precise images of the heart revealing calcium buildup in the arterial walls.
- Magnetic resonance angiography (MRA) – can reveal aneurysms, stiffness, and constriction of major arteries.
Complications of Atherosclerosis
Consequences vary depending on the arteries that are constricted or blocked. For instance:
- Coronary artery disease – narrowing of the heart’s arteries can cause a heart attack, chest pain, or a heart failure.
- Carotid artery disease – when the arteries supplying blood to the brain are restricted or obstructed, it may result in a temporary ischemic attack (TIA) or a stroke.
- Peripheral artery disease – causes blood flow issues in the arms and legs and reduces a person’s sensitivity to heat and cold, raising the risk of burns or frostbite in people.
- Aneurysm – is a bulge in any of the blood vessels and may have life-threatening internal bleeding from an aneurysm rupture.
- Chronic kidney disease – Enough blood cannot reach the kidneys because the arteries going there have narrowed resulting in the kidneys not being able to filter waste materials and eliminate extra fluid effectively.
Treatment may only involve making lifestyle modifications like eating well and exercising. But occasionally, it could be necessary to take medicines or have surgery.
- Atherosclerosis may be slowed down, stopped, or even reversed by medications for high blood pressure and cholesterol. They reduce the possibility of a person experiencing a stroke or heart attack. Statins, aspirin, niacin, bile acid sequestrants, and other medications are examples.
- Other risk factors like diabetes may also be managed with medicines.
More invasive methods
Depending on the severity of the symptoms or the presence of a blockage, the patient might require a more invasive procedure or surgery, such as:
- Angioplasty and stent placement – helps unblock or unclog an artery. Stenting aids in symptom relief but does not stop heart attacks.
- Endarterectomy – Sometimes surgery is required to clear plaque from an artery’s walls, allowing blood to flow again. In patients at higher risk, a stent may also be implanted during this procedure.
- Fibrinolytic therapy – A clot-dissolving medication may be used to dissolve the blood clot in the artery that is restricting blood flow.
- Coronary artery bypass graft (CABG) surgery – A healthy artery from another region of the body is used by the surgeon to construct a different route for blood to travel to the heart muscles. It involves an open-heart operation.
Lifestyle changes to avoid complications
Making the following lifestyle adjustments can help maintain healthy arteries and stop or halt the progression of the disease:
- Quit smoking – as it causes artery damage and increases the possibility of getting heart disease.
- Exercise regularly – as it decreases blood pressure, improves circulation, and minimizes the chance of heart disease.
- Keep moving – use the stairs instead of the elevator, go for a lunchtime stroll around the block, or perform some pushups and sit-ups while watching television.
- Maintaining body weight – lowers the chance of getting heart disease.
- Eating a heart-healthy diet – low in refined carbs, sugars, saturated fat, and sodium and high in fruits, vegetables, and whole grains can help manage blood pressure, body weight, cholesterol, and blood sugar.
- Always read the nutrition labels on packaged food to check for salt, sugar, and fats.
- Snack on carrot sticks, boiled peanuts, sprouts, apples, bananas, etc.
- Find techniques to lessen emotional stress – mindfulness, exercises, deep breathing exercises, and forming supportive relationships.
- Work with a healthcare professional to treat the condition and maintain overall health if you are already at a high risk of having high blood pressure, cholesterol levels, diabetes, or other chronic diseases.
The condition’s severity, how quickly a person received therapy, and whether or not other organs were impacted will all determine how well an individual responds to the treatment. The progression of atherosclerosis can be slowed down and prevented from getting worse using a range of treatments, including surgery, even if it cannot be reversed. Atherosclerosis patients can lead healthy, active lives with early diagnosis and treatment. But the situation could lead to medical issues and at times even be deadly. Therefore, it is crucial to be aware of the potential risks and take steps to reduce them in collaboration with a healthcare professional.