Atherosclerosis: Causes, Symptoms, and Prevention

What is Atherosclerosis?

Atherosclerosis, literally meaning hardening of the arteries, is a degenerative disease characterized by narrowing of the arteries. Deposits of lipids, fibrous cells, muscle cells, cholesterol crystals, and calcium build up on the artery walls. This process develops slowly.

When narrowing of the arteries prevents blood flow, it leads to ischemia (lack of blood supply to the tissues).

Understanding Atherosclerosis Development

• Atherosclerosis is a widespread condition, although there are notable differences in incidence based on geography, race, and sex.
• Although the term "atherosclerosis" is relatively modern, traces of artery hardening have been found in mummies from the Fifteenth Dynasty of Egyptian pharaohs (dating back to 1224 BC).
• The disease process begins in all individuals, regardless of origin, during the first 20 years of life. Initially, it develops as very mild, small plaques known as fatty streaks, which can be found early in life.
• We now know that each person is born with a unique three-dimensional geometry of their coronary arteries.
• A new element in the complex evolution of the atheromatous plaque is inflammation. The plaque can rupture, forming a clot or completely blocking the artery.

Atherosclerosis Risk Factors

Risk factors for atherosclerosis can be modified or are uncontrollable. Investigation into these factors began in the 1960s with epidemiological studies.

Factors that can be modified and contribute to atherosclerosis include:

• Smoking
• Hypertension (high blood pressure)
• High cholesterol, especially high LDL ("bad" cholesterol). HDL ("good" cholesterol) plays a protective role.
• Diabetes mellitus
• Obesity
• Sedentary lifestyle
• Stress

Uncontrollable factors include age, sex, and genetic predisposition/race.

Symptoms of Atherosclerosis

Symptoms depend on which arteries are affected:

• In the heart: Can cause chest pain (angina) or myocardial infarction (heart attack).
• In the lower extremities: Can cause leg pain when walking (intermittent claudication), requiring the person to stop.
• In the brain: Can cause minor symptoms, or more severe issues like paralysis of extremities due to ischemia.

High cholesterol is more strongly related to coronary artery disease, smoking to intermittent claudication, and hypertension to cerebrovascular accidents (stroke).

Atherosclerosis can potentially begin even before birth if the mother's cholesterol level is not properly managed during pregnancy. Between the ages of 14 and 30, the disease can advance significantly due to poor lifestyle habits.

Preventing Atherosclerosis

• Physical Activity: Exercise regularly, aiming for three or four sessions per week, 50 to 60 minutes of aerobic activity.
• Cardiovascular Diet: A healthy diet is highly recommended. Focus on calorie-appropriate plant foods like vegetables, fruits, and whole grains.
• Manage Excess Weight: Obesity is often associated with hypertension, increased uric acid, and high cholesterol.
• Control Hypertension: Manage high blood pressure through exercise, diet, and relaxation techniques.
• Quit Smoking: Nicotine contributes to the accumulation of cholesterol and damages arteries.