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Arteriosclerosis

Preeti (name changed) has been experiencing chest pain since past few days but ignored it. Although not every chest pain indicates a heart attack, it can signify an underlying heart condition. With severe pain in legs while walking from few days, she visited a doctor to find out the exact cause of her condition. Her doctor revealed that she was suffering from a heart condition known as arteriosclerosis. Like her, most people tend to ignore common signs and symptoms of heart disease until late in its course. Here's what you need to know about arteriosclerosis.

It is a condition that damages the inner layer of an artery, which ultimately increases your risk of coronary heart disease. Unlike atherosclerosis, this condition can be caused due to an inflammation of the arteries and cholesterol buildup in the blood vessels. With simple lifestyle modifications such as diet control, exercise and weight management, you can prevent arteriosclerosis.

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Symptoms

Dr Manoj Kumar, Associate Director & Head - Cardiac Cath Lab, Max Balaji Super Specialty Hospital, Patparganj, New Delhi says, 'The symptoms of arteriosclerosis usually depend on the arteries that are affected.' Here are some of the common signs of arteriosclerosis to watch out for:

1. Chest pain or pressure (angina): If you experience chest pain than it might mean that the coronary arteries are affected.

2. Numbness in arms or legs: It is one of the key symptoms of transient ischemic attack (TIA) in which the arteries present in the brain are affected.

3. Difficulty speaking: When you face difficulty in speaking even the simple day-to-day words, it means that the arteries of the brain are not functioning properly.

4. Drooping muscles in your face: It could be a vital sign of arteriosclerosis in which the blood vessels of the brain are blocked leading to an inefficient supply of oxygen to the organ.

5. Pain in legs while walking: This is a common symptom of peripheral artery disease in which the arteries of arms and legs are affected.

6. High blood pressure: If you suffer from high blood pressure it might indicate that you are suffering from arteriosclerosis. It could indicate inflammation in the blood vessels that supply blood to the heart or various parts of the body.

7. Kidney failure: If the arteries that supply blood to the kidneys are affected, you may suffer from kidney failure. And this in turn might indicate arteriosclerosis.

8. Erectile dysfunction: If you are facing difficulty in having sex or are suffering from erectile dysfunction, it might indicate that the arteries present in the genital area are affected.

Causes

The main causes of arteriosclerosis are -

High blood pressure: One of the key causes of arteriosclerosis is high blood pressure level or hypertension. When you have high blood pressure, excess pressure is exerted on the walls of the arteries which in turn increases your risk of suffering from arteriosclerosis.

High cholesterol: High blood levels of cholesterol mostly due to high saturated fat and cholesterol-rich diets (high LDL, bad cholesterol), make you are more prone to arteriosclerosis.

Smoking and other sources of tobacco: When you smoke, numerous harmful chemicals get accumulated on the walls of the arteries and are transported to various parts of the body through blood. And with time, these chemicals put you at risk of suffering from this condition. Here are 25 things that happen in your body when you smoke.

Diabetes: If your blood sugar levels are not within control, there is high chance that your arteries may find it difficult to pump blood to various parts of the body. And in turn increase our pressure and lead to arteriosclerosis.

Inflammation: It is quite common that diseases such as arthritis, lupus or infections or an inflammation of unknown cause might increase your risk of arteriosclerosis. Because, this might cause the inflammatory molecules to flow through blood and lead to accumulation in the blood vessels.

Diagnosis

The common diagnostic tests that are used to determine whether you suffer from arteriosclerosis or not are -

1. Physical examination: In this your doctor might examine your pulse,
check your chest with the help of a stethoscope for the following --


  • A weak or absent pulse below the narrowed area of your artery

  • Decreased blood pressure in an affected limb

  • Whooshing sounds over your arteries on examination with a stethoscope

  • Evidence of pulsating bulge (an aneurysm) in abdomen or behind knee

  • Poor wound healing in the blood flow restricted area


2. Blood tests: These usually include lipid profile tests to detect blood levels of LDL (Low-Density Lipoprotein), triglycerides, and total cholesterol. In some cases, blood sugar levels are also recommended as they are the major contributing factors for arteriosclerosis.

3. Doppler ultrasound: It is done to measure blood pressure at various points along the arm or leg. These measurements are indicative of the grade of any blockages and the speed of blood flow in the arteries.

4. Ankle-brachial index: This test is usually recommended to diagnose arteriosclerosis in legs and feet (peripheral artery disease). It is called ankle-brachial index as the blood pressure of ankle is compared with that in the arm.

5. Electrocardiogram (ECG): Any abnormalities in the frequency of heart beat or timing of the electrical signal recorded in the ECG indicate cardiovascular problems. In this, electrodes are placed on the chest to record electrical signals that pass through the heart. to know more about ECG, click on the link.

6. Stress test (Exercise stress test): This test provides information about the heart activity during a physical exercise.

7. Cardiac catheterization and angiogram: It includes tests like X-ray that reveals the blockade in the arteries after injecting a liquid dye.

8. Imaging techniques: These are majorly computerized tomography (CT) scan or magnetic resonance angiography (MRA) that reveal stiffening/ narrowing of the arteries, aneurysms and calcium deposits in the artery walls.

Treatment

The treatment options for people suffering from arteriosclerosis include pharmacologic treatment (medications) and or surgery.

I. Pharmacologic treatment includes -

1. Cholesterol medications: The aim of these medicines is to lower LDL cholesterol and improve HDL cholesterol in your body. The medications that are commonly prescribed in such cases are statins like atorvastatin and fibrates. In addition to lowering cholesterol, statins also help in stabilizing the lining of arteries and prevent atherosclerosis.

2. Anti-platelet medications: These drugs reduce the chances of platelet aggregation in narrowed arteries that in turn increase the risk of arterial blockage leading to arteriosclerosis. Experts usually recommend aspirin to prevent platelet aggregation.

3. Beta-blocker medications: These medications, for example, atenolol, and metoprolol, lower heart rate and blood pressure. They are commonly used to treat coronary artery disease.

4. Angiotensin-converting enzyme (ACE) inhibitors: They lower blood pressure and thus slow down the process of arteriosclerosis. The commonly prescribed ACE inhibitors are ramipril and enalapril.

5. Calcium channel blockers: These medications (like amlodipine) lower blood pressure and are sometimes used to treat angina.

6. Water pills (diuretics): Diuretics like hydrochlorothiazide (HCTZ) lower blood pressure by aiding in the urine formation that in turn decrease the pressure exerted on the arteries by the fluid flowing through blood vessels.

II. Surgical procedures that are used to treat arteriosclerosis are -

Angioplasty and stent placement: In this, the blocked or narrowed arteries are opened up. In some cases, a stent is placed to improve blood flow to the heart. Here's what you need to know about angioplasty.

Endarterectomy: In some cases, fatty deposits must be surgically removed from the walls of a narrowed artery and thus, endarterectomy is recommended.

Thrombolytic therapy: This therapy involves the use of a clot-dissolving drug. Depending upon the severity of the condition and the location of the clot, your doctor will decide whether to go for this therapy or not.

Bypass surgery: If there is a blockage in the coronary artery -- an artery that supplies blood to other parts of the body, bypass surgery is recommended. In this, a healthy blood vessel is grafted (transplanted) in place of the blocked artery. To know more about bypass surgery and life after it, read this.

Complications

If arteriosclerosis is left untreated or not treated in time, it can lead to -

Prevention

Five ways to reduce risk of developing further coronary heart disease:


  • A healthy diet

  • Quit smoking (if you smoke)

  • Regular exercise

  • Lose weight (if you are overweight or obese)

  • Only moderate consumption of alcohol


Diet: Here are some dietary tips you need to keep in mind.

  1. Avoid foods that contain saturated fats as they increase the LDL cholesterol levels. Say no to foods like meat pies, sausages and fatty cuts of meat, butter, ghee, lard, cream, hard cheese, cakes and biscuits, coconut or palm oil.

  2. Include foods with unsaturated fat as they increase the HDL cholesterol levels. These are oily fish, avocados, nuts and seeds, sunflower, rapeseed and olive oil. Here's what you need to eat to keep your heart healthy.

  3. Don't forget to include cholesterol-lowering foods in your diet. These are sterols and stanols that reduce LDL cholesterol levels. They are found in fruits, vegetables, nuts, seeds, cereals, legumes (such as beans or peas), olive oil and vegetable oil. Intake of 2,000mg of sterols and stanols a day reduces levels of LDL cholesterol by around 10%, which in turn reduce the risk of heart disease by around 25%. The average recommended intake of plant sterols and stanols is about 100-450mg.

  4. Lower your salt intake as it increases your blood pressure. Hence, aim to eat less than 6g (0.2oz) of salt a day, which accounts to about a teaspoon.


Smoking: It goes without saying that smoking is a major risk factor for both a heart attack and stroke because it causes atherosclerosis and raises blood pressure. Here's how you can start your journey to quit smoking.

Alcohol: Alcohol intake should be in recommended levels. The recommended limits for alcohol consumption are 3-4 units/day for men and 2-3 units/day for women. And anything more than this can elevate your risk of heart problems.

Weight: Increased weight can lead to high blood pressure. So maintaining a normal BMI is recommended. Here's how to keep a tab on your weight.

Exercise: Regular exercise is the key to weight loss that in turn helps in lowering the blood pressure and hence lowers your risk of suffering from arteriosclerosis. Wondering how to go about it? Here is a step-by-step guide for a healthy heart.

 

The content has been verified by Dr Manoj Kumar, Associate Director & Head - Cardiac Cath Lab, Max Balaji Super Specialty Hospital, Patparganj, New Delhi.

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