Atherosclerosis: Causes and Treatment

Apr 24, 2015 |

Atherosclerosis is a hardening and narrowing of the arteries (which are the blood vessels that transport away the blood from the heart) occuring over years or decades. The narrowing of the arteries causes decreased blood flow to organs and body parts. Despite decades of research today we still do not know exactly why atherosclerosis occurs. As secured all agree that there is a predisposition to atherosclerosis and its consequences – heart attack and stroke. Also, we know that women at a younger age have a natural protection from atherosclerosis thanks to female sex hormones. However, this natural protection subsides with the onset of menopause.

Inheritance is Gender-Dependent

In Search of the gene that is responsible for hardening of the arteries, a scientist at the University of Leipzig who conducted a research on two strains of mice made an amazing discovery: arteriosclerosis can be inherited only from the opposite sex. ”The passing of the gene that is responsible for arteriosclerosis is dependent on the sex of the parent generation. Males exhibiting this gene will have a mother who also posesses it. Conversely, a female descendant of this gene will have corresponding male ancestors,” said the scientist Dr. Teupser. ”So we want people to understand that problems resulting from atherosclerosis, such as heart attack or stroke, may be inherited – and we must consider the inheritance line.”

Onset Goes Largely Unnoticed

Atherosclerosis is not built up overnight. It may take 20 to 40 years before the first symptoms occur – but by then the problem is already serious nature. Resulting issues include, for example, circulatory problems in the legs, because the narrowed arteries are poorly supplied with oxygen or a narrowing of the coronary arteries, which leads to angina pectoris. Other symptoms may include a decline in brain function, including memory problems or dizziness.

In addition to the hardening of the arteries, further progression of atherosclerosis can cause arterial occlusion that totally interrupts the blood supply, therefore causing a lack of oxygen to organs and extremities. The heart, brain and legs are most commonly affected by atherosclerotic disease.

Risk Factors for the Development of Atherosclerosis

Atherosclerosis is accelerated by certain health and lifestyle factors which accelerates it’s natural course. These include:

  • High blood pressure
  • Diabetes mellitus
  • Lack of exercise, obesity
  • High-fat, unbalanced diet
  • Stress
  • Smoking (as nicotine constricts blood vessels)
  • High uric acid levels
  • Increased fibrinogen levels (blood clotting)
  • High homocysteine ​​levels
  • Vitamin deficiencies
  • High cholesterol (cholesterol is deposited in the vessels)

Patients with these risk factors should should consult a physician for regular checkups.

Development of Atherosclerosis

The vessels are lined with a smooth, thin cell layer called the intima. Keep certain harmful effects can occur over time causing small cracks in this lining. When this happens, not unlike what happens with a wound, the body’s immune system is activated and it sends out it’s helpers. But these repairs are less than optimal: liquid penetrates into the vessel wall, swelling occurs and blood cells, fat and calcium are formed as a result.

As this protective reaction thickens the inner vessel wall, something called a sebaceous cyst is formed. The term comes from the Greek meaning “porridge” because of the resultant thickening. Over time, more and more lime is deposited and the vessel wall hardens, forming the so-called plaque. From this point on it is called atherosclerosis. This narrowing of the blood vessel often does goes unnoticed for a long time.

Such processes also take place in the small arteries that supply the heart with nutrients. There the circulatory disorders usually are noticed only when the vessels are only about one-third open. Then the typical symptoms begin to manifest: shortness of breath and pain in the legs or chest.

Since atherosclerosis develops very slowly, the vascular system can form “bypass circuits” (collateral vessels). The body uses existing vessels to continue to provide this “diversion” the heart muscle with blood. If such collateral circulation exists, complaints may be absent despite a clogged vessel at the heart.

Small Cause – Big Effect

Things become critical when deposits detach from the vessel wall,  and small particles or the entire plaque breaks off. Then the vessel may be suddenly completely clogged. This cuts off the underlying storage vessel portion of the blood flow. The cells normally supplied with blood die. When this happens to the whole heart, a heart attack occurs, and the obstruction of cerebral vessels can lead to a stroke – with serious health consequences.

Recent studies show that the greatest danger does not come from the thickest deposits, but small, soft plaques. These plaques are unstable, and have a thinner membrane and a fattier core. Sudden physical exertion or blood pressure fluctuations can rupture this thin membrane, after which often a blood clot is formed.

Preventive Measures

Although every person is susceptible to this vascular disease with age, with a healthy lifestyle it develops much more slowly. Our vessels are designed by nature for many decades of blood flow. For those who want to stay healthy, the best prevention is a sensible diet and exercise. Besides prevention it’s important to minimize as many risk factors as possible:

  • Regular monitoring of blood pressure and cholesterol levels.
  • Reduce cholesterol levels in the diet (butter, eggs, meat).
  • Diabetics should always ensure that their glucose levels are controlled.
  • Stop (or at least reduce) smoking
  • Obese persons should seek weight loss treatment.

Treatment of arteriosclerosis

If you are at increased risk of atherosclerosis and have symptoms such as pain when walking or numbness in the legs see a doctor promptly. He or she scans to measure the blood pressure and apply necessary imaging procedures. Having an angiography  makes clogged veins visible. If the vasoconstriction is in the basin, the bottleneck can be expanded using a balloon catheter. This is introduced into the constriction and inflated to expand the artery.

A bypass, redirecting the bloodstream, or a support, called a stent, may be used. In addition, drugs such as blood pressure or cholesterol-lowering agents are used. Atherosclerosis can not fully heal, but the gradual and dangerous disease progression can be significantly slowed.

Posted in: Cardiology Health Basics, EJCPR

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