Conditions Meds Physician Topic

Atherosclerosis : The slow killer

What is Atherosclerosis?

It can simply be defined as the hardening and narrowing arteries which silently and slowly blocks arteries, putting blood flow at risk.
It is usually the cause of heart attacks, stroke, peripheral vascular disease which is collectively called Cardiovascular diseases.
To understand atherosclerosis, one must know how it puts blood flow at risk. We start from understanding the arteries: Arteries are blood vessels that carry blood from the heart throughout the body. These arteries are lined by thin endothelium which works to keep the inside of the arteries toned and smooth, therefore keeping blood flowing.

Atherosclerosis begins with damage to the endothelium which is caused by high blood pressure, smoking or cholesterol. The damage leads to the formation of plaque.
When cholesterol and LDL(low density lipoprotein) crosses the damaged
endothelium, the cholesterol enters the wall of the artery causing
your white blood cells to stream in to digest the LDL. Over years
,these cholesterol and cells become the wall of the artery
thereby slowing down the velocity of blood flow through the vessels.

Atherosclerosis is not a diagnosis or a disease but it leads to heart diseases
factors affecting atherosclerosis are divided into:
Modifiable factors(factors that can be controlled) and
Non-modifiable factors(factors we can do nothing about/we cannot control).
The modifiable factors include:
*Diabetes Mellitus
*Cigarette smoking.
The non-modifiable factors include:
*Age(Risk increases with aging)
*Sex/Gender as estrogen in premenopausal women is protective.
*Genetic predisposition as some genetic conditions associated with
formation of plaques(familial dyslipidemias).
These plaques affect important arteries like the aorta and disrupts blood flow
Plaques creates a bump in artery wall, as atherosclerosis
progresses,the bump gets bigger and causes block to the artery which
could lead to heart problems,stroke and other health issues.

Plaques can behave in certain ways:

*they can stay in the artery wall in which it grows to a certain size and stops,since it doesn’t block flow ,it will cause no symptoms
*plaques can grow in a slow controlled way in the path of blood flow causing significant block and manifests as chest pain and leg pain.
*plaque can become very serious if they rupture in the blood vessel and moves through the blood and vital organs like the brain and heart causing stroke and heart attack respectively.


Plaques causes three main kinds of cardiovascular disease:
1. Coronary artery disease: the coronary artery, the main supply of blood
to the heart if blocked by stable plaques gives rise to angina(chest
pain) and if it suddenly ruptures leads to clotting and causes death
of heart muscles(heart attack/myocardial infarction).

2. Cerebrovascular disease: Ruptured plaques in the brain arteries causes
stroke with potential for permanent brain damage. temporary block in
arteries leads to transient ischemic attack which are warning signs of

3. Peripheral vascular disease:Narrowing in the arteries of the legs
causes poor circulation and cause pains in the leg.If very severe can
lead to amputation ,it could also present with lack of wound healing.
Atherosclerosis starts early as the autopsy of young soldiers show
atherosclerotic plaque.

In a test of relatively healthy people,52% of them had atherosclerosis
so people above 40 though healthy may have atherosclerosis or risk of
it .

Atherosclerosis can get worse with time but can be prevented.
9 risk factors responsible for heart attacks due to atherosclerosis include:

  1. Smoking
  2. High cholesterol
  3. High blood pressure
  4. Diabetes
  5. Abdominal obesity
  6. Stress
  7. lack of fruits and vegetables
  8. excess alcohol intake.

Somethings can be done about them and experts agree that controlling these risks reduce the odds for cardiovascular disease. For people with moderate or higher risk which includes those that have had a stroke,heart attack or angina(chest pain) aspirin a day is important as it prevents clot though medical advice from doctors should be gotten as it could have is side effects.

Other treatments like sublingual nitroglycerine, clopidogrel and others which used with medical advice could be helpful.

Once a plaque is gotten,it is there to stay but with medication and
proper lifestyle changes,the plaque may slow or stop growing and may
shrink slightly with aggressive treatment .
As H.L.Mencken said “As the arteries grow hard, the heart grows soft”
,proper knowledge and right application of healthy living is
important. Remember health is wealth.

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