The terms can be a little confusing. "Athero"-sclerosis is a disease in which fatty material is deposited on the wall of your arteries, which narrows the arteries and eventually restricts blood flow. It is one of several types of "Arterio"-sclerosis, a disease characterized by thickening and hardening of artery walls. However, the word "atherosclerosis" is often used to indicate any of the forms of arteriosclerosis.
Alternative Names
Arteriosclerosis; Hardening of the arteries
Causes, incidence, and risk factors
Atherosclerosis is a common disorder of the arteries. Fat , cholesterol , and other substances accumulate in the walls of arteries and form "atheromas" or plaques. Eventually, the fatty tissue can erode the wall of the artery, diminish the elasticity (stretchiness) of the artery, and interfere with the blood flow. Clots may form around the plaque deposits, further interfering with blood flow. When blood flow in the arteries to heart muscle becomes severely restricted, it leads to symptoms like chest pain . Risk factors include smoking , diabetes , obesity , high blood cholesterol , a diet high in fats , and having a personal or family history of heart disease . Cerebrovascular disease , peripheral vascular disease , high blood pressure , and kidney disease involving dialysis are also disorders that may also be associated with atherosclerosis.
Signs and tests
Atherosclerosis may not be diagnosed until complications occur. Prior to complications, atherosclerosis may be noted by the presence of a "bruit" (a whooshing or blowing sound heard over the artery with a stethoscope). The affected area may have a decreased pulse. Tests that indicate atherosclerosis (or complications) include:
An abnormal difference between the blood pressure of the ankle and arm (ankle/brachial index, or ABI) A Doppler study of the affected area Ultrasonic Duplex scanning A CT scan of the affected area
Magnetic resonance arteriography (MRA) An arteriography of the affected area
An intravascular ultrasound (IVUS) of the affected vessels
Treatment
To some extent, the body will protect itself by forming new blood vessels around the affected area. Medications may be recommended to reduce fats and cholesterol in your blood. These include cholestyramine, colestipol, nicotinic acid , gemfibrozil, probucol, lovastatin, and others. Aspirin, ticlopidine, and clopidogrel (inhibitors of platelet clumping) or anti-coagulants may be used to reduce the risk of clot formation. Balloon angioplasty uses a balloon-tipped catheter to flatten plaque and increase the blood flow past the deposits. The technique is used to open the arteries of the heart and other arteries in the body. Another widely used technique is stenting , which consists of implanting a small metal device inside the artery (usually following angioplasty) to keep the artery open. Surgically removing deposits (endarterectomy) may be recommended in some cases. A bypass graft is the most invasive procedure. It uses a normal artery or vein from the patient to create a bridge that bypasses the blocked section of the artery.
Expectations (prognosis)
The outcome varies. All people begin to develop atherosclerosis at birth, and in some people, it leads to complications.
Calling your health care provider
Call for an appointment with the health care provider if you are at risk for atherosclerosis, particularly if symptoms of complications occur.
Prevention
Diet recommendations may include low-fat , low-cholesterol, and low-salt diet. Follow the health care provider's recommendations for treatment and control of hypertension , diabetes , and other diseases. Reduce body weight if overweight and stop smoking if a smoker. Get regular exercise to improve the fitness of the heart and circulation.