Introduction
According to the National Heart, Lung, and Blood Institute, about 50% of Americans between the age of 45 and 84 have atherosclerosis but are unaware of it. It develops when a sticky substance called plaque builds up in your blood vessels that carry blood away from the heart (arteries). This can eventually lead to a blood clot that blocks oxygen-rich blood from reaching vital organs. A plaque buildup may begin as early as childhood but usually manifests in adulthood as stroke, angina, or heart attack. There are multiple treatment options for atherosclerosis. It is a good idea to explore all possible options before making a final call. Many prominent research institutes in the United States conduct clinical trials in Michigan, working toward new treatment options.
Stages of Atherosclerosis:
Atherosclerosis may take years to progress, thus it can be divided into multiple stages. These may include:
- Endothelial damage and immune response: This is the first step. Atherosclerosis begins with endothelial damage. Many factors like high amounts of low-density lipoproteins (LDL), cholesterol, and toxins from tobacco-based products cause damage to the walls of the arteries. White blood cells respond by traveling to the injury site.
- Fatty streak formation: Atherosclerosis becomes visible when a fatty streak forms. It is a foam that appears when white blood cells consume cholesterol.
- Plaque growth: With the continued build-up of dead cell debris, the fatty streak turns into larger plaques. Furthermore, a fibrous cap appears over these streaks, preventing these streaks from breaking down and constricting the artery lumen at the same time.
- Plaque rupture or erosion: Plaque erosion causes the formation of a blood clot. This clot can clog the arteries leading to a stroke or heart attack.
What Are the Symptoms of Atherosclerosis?
In atherosclerosis, the symptoms appear very late when someone is nearing a heart attack or a stroke. Symptoms can also vary based on the type of artery blocked.
Coronary artery symptoms can include:
- Arrhythmia (an unusual change in the normal pattern of the heartbeat)
- Pain or pressure in your upper body, including your chest, arms, neck, or jaw. This is known as angina.
- Shortness of breath
If a blockage occurs in the vessels that carry blood to the brain, the following symptoms may appear:
- Numbness or weakness in your arms or legs
- A hard time speaking or understanding someone who’s talking
- Drooping facial muscles
- Paralysis
- Severe headache
- Trouble seeing in one or both eyes
Additionally, if the blockage is in the arms, legs, and pelvis, you may feel:
- Leg pain when walking
- Numbness
Risk Factors For Atherosclerosis:
Hardening of the arteries occurs over time. Along with this, aging is another risk factor for Atherosclerosis. Additional factors that increase the chances of Atherosclerosis are:
- A family history of early heart disease
- An unhealthy diet
- Diabetes
- Elevated blood pressure
- Raised cholesterol
- High levels of C-reactive protein
- Lack of exercise
- Obesity
- Sleep apnea
- Smoking and other tobacco use
Complications:
There are multiple complications of atherosclerosis depending on the type and location of the arterial blockage. For example:
- Coronary artery disease: If the blockage is in the arteries close to the heart, you can develop coronary artery disease which can result in chest pain (angina), heart failure, or heart attack.
- Carotid artery disease: The carotid artery supplies blood to the brain. When this vessel narrows, you may develop carotid artery disease which can result in transient ischemic attack (TIA) or stroke.
- Peripheral artery disease: When arteries narrow in your arms and legs you can develop blood flow problems known as peripheral artery disease. This increases your sensitivity to hot and cold predisposing you to frostbite, burns, and even gangrene.
- Aneurysms: An aneurysm is when the blood vessel dilates. A medical emergency may occur if the aneurysm bursts. Some people may not have any symptoms. For others, pain and throbbing in the area of the aneurysm may warrant medical attention.
- Chronic kidney disease (CKD): Atherosclerosis can also cause the arteries of the kidneys to narrow down leading to hindrance in blood flow. This prevents oxygen-rich blood from reaching the kidneys.
Prevention:
The lifestyle changes that are suggested for atherosclerosis also help prevent it. These lifestyle changes are:
- Quit smoking
- Eat healthy foods
- Exercise regularly
- Maintain a healthy weight
- Check and maintain a healthy blood pressure
- Have healthy cholesterol and blood sugar levels
What are the Tests for Atherosclerosis?
Your healthcare provider may order additional tests to diagnose atherosclerosis and plan treatment. These tests include:
- Angiography
- Ankle/brachial index
- Chest X-ray
- CT scan
- Echocardiogram (echo)
- Electrocardiogram (EKG)
- Exercise stress test
- Carotid ultrasound
- Abdominal ultrasound
How Do You Treat Atherosclerosis?
Once a blockage develops, it is usually there to stay. Medications and lifestyle changes, though, can slow or stop the development of plaques. It can even shrink the plaque with aggressive treatment options. Some measures that may help are:
- Lifestyle changes: One can slow the progression of atherosclerosis by taking care of the risk factor. This means should exercise, maintain a healthy weight, and avoid smoking. These changes can lower the risk of heart attack and stroke.
- Medication: Antiplatelets and antihypertensive drugs help lower the risk of cardiovascular disease and stroke. They will also slow down and stop atherosclerosis.
There are other more invasive procedures for opening blockages resulting from atherosclerosis:
- Angiography and stenting: A thin artery from your leg or arm is used to replace a diseased artery. A doctor puts a thin tube into a large artery, usually in the arm or leg, to access the diseased artery. A clogged artery may frequently be opened by angioplasty (the use of a catheter with a balloon tip) and stenting.
- Bypass surgery: In bypass surgery, your doctor can take a healthy blood vessel and use it to bypass a blocked segment.
- Endarterectomy: Access is made through the neck to remove plaque and restore blood flow.
- Fibrinolytic therapy: A medication breaks a blood clot that is obstructing your artery.
The Takeaway
Atherosclerosis is a chronic inflammatory disorder of the arteries in which plaque builds up over time and constricts the flow of oxygenated blood to vital organs. It is a public health menace affecting millions of people. Through proper management, such as lifestyle modification, regular exercise, a healthy diet, and smoking cessation, its adverse effects can be reduced. Treatments comprise lifestyle modification and medications and surgeries in more aggressive stages. Even with invasive treatments the clot never fully goes away which is why research institutes are busy enrolling people for atherosclerosis clinical trials. After reading this blog you may also want to explore these potential treatment options.
