Atherosclerosis is a condition in which the arteries get blocked due to the deposition of fatty substances, cholesterol and and abnormal cells on the walls of the arteries. Though anyone can suffer from atherosclerosis, there are a few risk factors which put a person at a higher risk of developing atherosclerosis.
A block in the arteries is actually caused by narrowing and thickening of the walls of arteries due to the deposition of fatty substances such as cholesterol along with other cellular waste. The substances that get accumulated along the arteries form a buildup called plaque or atheroma. Plaques are mainly dangerous because they narrow the arteries, restrict the blood flow and can hamper the functioning of several organs. Plaques can also rupture and result in a blood clot which again blocks the blood supply to the heart. These conditions either trigger a heart attack or a stroke affecting the brain. Read more about causes, symptoms, diagnosis and treatment of peripheral vascular disease.
Atherosclerosis is a slow disease and takes really long time to progress and cause complications. In a few people, plaque formation may start during childhood and may advance rapidly during 30s. In others, it doesn’t really pose a threat until 50s or 60s. With all advances in surgical and operative procedures, people who initially show the symptoms of heart attack can prevent the complications in advance. But, people in whom any signs are not seen at an early stage are at a greater risk. (Read: Silent heart attacks: Why you need to be aware)
The exact cause of atherosclerosis is unknown. However, there are several factors that may increase the risk cardiovascular diseases due to atherosclerosis. Permanent risk factors include increasing age and a family history of heart disease.
Read about 6 causes of high cholesterol you didn’t know.
Risk factors that can be controlled by changing lifestyle include:
- Smoking: It damages walls of the arteries, raises blood pressure and reduces good cholesterol (HDL) levels. It also causes blood clots by aggregating platelets at the site of damage
- Physical inactivity
- Dyslipidemia: High bad cholesterol ( LDL), Triglyceride and low good cholesterol ( HDL)
- Sleep disorders (Read: What are the biggest heart attack risks for Indians?)
The risk of heart diseases also increases under certain health conditions such as:
Researchers suspect that high blood levels of protein called C-reactive protein (CRP) might increase the risk of atherosclerosis and attacks. High blood levels of triglycerides, especially in women, may also increase the risk. (Read: 70% of the urban Indian population at risk of heart disease!
Atherosclerosis is a silent condition and may not show any symptoms until the affected artery is blocked enough to disturb the blood blow and deprive the organs and tissues of sufficient blood supply. However, with partial block of arteries, the following signs may be seen:
- Anginal chest pain: Choking type of chest pain at the middle of the chest, sometimes radiating to neck or upper arm. It appears especially during exertion and disappears during rest or sublingual sorbitrate. Angina chest pain appears due to blockage of arteries supplying blood to heart muscle.
- Sudden numbness or weak and dizzy feeling or brief loss of consciousness or loss of function of a part of body due to blockage of the carotid arteries (in the neck) that supply blood to the brain indicating the possibility of stroke.
- Pain in leg muscles while walking due to blockage of arteries that supply blood to the limbs indicating the possibility of peripheral arterial disease.
- Erectile dysfunction may occur occasionally in men due to hardening of the arteries. (Read: You’re likelier to get a heart attack or suffer a stroke in the morning!)
There are several diagnostic methods used to confirm atherosclerosis. When you present to the doctor for clinical evaluation, a physical examination is first conducted. When you present to the doctor , a detailed history is taken. Physical examination is conducted.Following that, your doctor may recommend you any of the following tests:
- Blood Test: A blood test is done to detect the level of cholesterol, fats and sugar in the blood. Abnormal levels may indicate risk for atherosclerosis.
- ECG (Electrocardiogram): ECG detects the electrical activity and rhythmic pattern of the heart. Specific electrical and rhythmic patterns can indicate the possibility of heart disease.
- Echocardiography: In this test, the sound waves from reflected from the heart muscles create moving picture and offers information about how well the heart is functioning.
- CT Scan: A CT coronary angiography can show thickening and narrowing of arteries of heart.
Other tests like a chest X-ray can be suggested to analyze the structures of heart and blood vessels and detect the signs of heart failure. An ankle-brachial index is taken to compare blood pressure of the ankle with the blood pressure of the arm. An abnormal index may indicate peripheral vascular disease caused by atherosclerosis. (Read: Obese people always likelier to suffer a heart attack)
Cholesterol lowering drugs: The main cause of atherosclerosis is deposition of cholesterol on the walls of the arteries. And, there are various cholesterol lowering drugs (containing statins and fibrates) that you may be prescribed for getting cholesterol under control. However, these drugs are just to bring cholesterol down to a safe level. To maintain good cholesterol levels you should have a healthy diet control and involve regular physical activity in your daily routine. (Read: World Heart Day 2013: Expert tips to prevent heart disease)
Other medications that are used to treat this condition include -
- Drugs containing may be given for slowing down cholesterol deposition.
- Anti-platelet drugs such as aspirin may be prescribed to reduce the chances of blood clot and further narrowing of arteries.
- Anticoagulants such as heparin or warfarin may be given to prevent clot formation.
- Drugs such as beta blockers, angiotensin-converting enzyme (ACE) inhibitors and calcium channel blockers may be prescribed for controlling blood pressure and slow down the progression of atherosclerosis.
What if medicines do not work? Are there surgical options?
In case of severe symptoms or malfunctioning of an organ, the following procedures may be carried out:
- Angioplasty: This procedure involves widening the blocked arteries with the help of a balloon and stent that compresses the plaque against the artery.
- Bypass surgery: The surgeon may graft a healthy blood vessel from some other part of your body to bypass the blockage in the narrowed artery. This allows blood to flow around the blocked or narrowed artery.
- Endarterectomy: Sometimes, the fat deposits may be surgically removed from the walls with endarterectomy. (Read: Stave off heart disease, eat fibre rich foods)
Life style modification goes a long way in preventing atherosclerotic disease. So, exercise regularly and improve circulation, eat healthy and stay fit, quit smoking and live a stress-free life.
The content has been verified by Dr. Santosh Kumar Dora, Cardiac Electro Physiologist, Asian Heart Institute, Mumbai.