What is Arteriosclerosis?

What is Arteriosclerosis

What is Arteriosclerosis? Arteriosclerosis is also popularly known as hardening of the arteries. Atherosclerosis is caused by the normal aging process, which is why older people are most often affected by vascular calcification. Around every fifth elderly person suffers from it.

What is Arteriosclerosis?

Atherosclerosis is when the blood vessels narrow due to deposits in the arterial walls. These can be formed from substances that circulate in the blood, such as blood lipids, connective tissue or calcium. Doctors also speak of plaques. In principle, these deposits can form on all vessels in the body, but they preferably occur on the neck, heart, brain, pelvis or arteries in the legs.

The consequences of hardening of the arteries are cardiovascular diseases, which are one of the most common causes of death worldwide. The deposits make the blood vessels less elastic, constrict them and thus impede the flow of blood through the vessels. In the worst case, a clot of blood platelets (thrombus) forms and the blood flow is completely interrupted. If a coronary artery closes, a heart attack occurs. If one of the cerebral vessels is blocked, the affected person suffers a stroke (ischemic cerebral infarction).

In addition to age, there are other risk factors for arteriosclerosis: Smoking, obesity, lack of exercise or high blood pressure also promote the vascular disease.

The first changes in arterial vessels occur in 15 to 19-year-olds if there are corresponding risk factors, such as obesity or increased blood lipid levels. In 30 to 40 year olds, pronounced symptoms of arteriosclerosis can already appear.

What are The Causes of Atherosclerosis?

The exact causes of arteriosclerosis are not yet known. However, it is known that the disease is preceded by damage to the inner layer of the vascular wall. This can happen through viruses, certain immune processes or the metabolic products of bacteria. This damage ensures that fats and lime particles accumulate there.

It has been proven that certain risk factors promote the development of hardening of the arteries:

  • Age: The main risk factor for arteriosclerosis is age, because the natural aging process causes the blood vessels to stiffen.
  • A diet high in calories and high cholesterol increases the levels of harmful cholesterol (LDL).
  • Overweight: The excess kilos also put a strain on the blood vessels.
  • In the long term, high blood pressure damages the blood vessels and thus promotes the deposition of plaques.
  • Smoking stimulates the formation of unstable plaques that can break open.
  • Diabetes mellitus: A permanently high blood sugar level damages the blood vessels – they “saccharify”.
  • Sedentary lifestyle increases blood pressure and cholesterol levels.
  • Physical and emotional stress have a negative effect on blood vessels.
  • Male sex: The female sex hormone estrogen protects women from arteriosclerosis, at least before menopause.
  • Genetic factors: Some people have hereditary factors to produce high levels of lipoprotein a. This protein transports cholesterol in the blood. It can cause inflammation in the blood vessels and make deposits in the vessel walls unstable. Diet or a healthy lifestyle cannot influence his concentration. Heart attacks, strokes and diseases of the blood vessels in the legs or pelvis occur more frequently in some families.

What are the Atherosclerosis Symptoms?

The vascular disease can in principle affect all vessels in the body – large (macroangiopathy) and small (microangiopathy). Depending on where in the body an artery is narrowed, different symptoms or diseases appear:

  • Peripheral arterial disease (PAD, smoker’s leg or intermittent claudication): the arteries in the legs or pelvis are narrowed; When walking or exercising, the affected person feels pain due to the reduced blood flow;
  • Coronary artery disease (CHD): one or more coronary arteries are narrowed due to arteriosclerosis; Symptoms include tightness in the chest or chest pain in the left side (angina pectoris); if the vessel is closed, there is a risk of a heart attack;
  • Atherosclerosis of the carotid arteries and arteries supplying the brain: if the carotid artery is blocked by a blood clot, a stroke can result. Symptoms include dizziness, confusion, paralysis, or memory and speech disorders.
  • Atherosclerosis of the renal arteries: the kidneys no longer function adequately, kidney-related high blood pressure develops, which can extend to kidney failure.
  • Atherosclerosis develops slowly. Usually the first symptoms only appear with increasing age. However, even 30 to 40 year olds can perceive symptoms of hardening of the arteries.

How Does the Doctor Recognize Arteriosclerosis?

The diagnosis begins with the patient’s medical history (anamnesis). It already provides initial indications of existing risk factors for arteriosclerosis.

Further investigations are:

  • Blood Test: It shows whether you have lipid metabolism disorders (high cholesterol levels, generally increased blood lipids, overall imbalance in blood lipids) or diabetes.
  • Blood pressure measurement: shows whether the patient suffers from high blood pressure .
  • Weight: The determination of the body mass index shows whether you are overweight or obese. The measurement of the waist circumference also gives the doctor clues.
  • Measure walking distance: If PAD is suspected, the doctor determines the walking distance that the patient can walk painlessly.
  • Ultrasound (sonography): This is how the condition of the blood vessels in the limbs can be determined. Changes in the vessel walls and the flow of blood in the vessels are visible. The more risk factors a patient has, the greater the thickening of the arterial wall.
  • Angiography: The method works with X-ray contrast medium – a liquid that is clearly visible in the X-ray image. This is the most reliable way of demonstrating the degree of vascular narrowing.
  • Computer or magnetic resonance tomography (magnetic resonance tomography, MRT): The method also provides reliable information about the condition of the vessels.
  • Electrocardiogram (EKG), stress EKG, cardiac ultrasound (echocardiography), so-called stress echocardiography and cardiac catheters are used to diagnose sequelae of arteriosclerosis in the heart. These include angina pectoris and heart attack (myocardial infarction).
  • The duplex sonography – a special ultrasound – shows narrowing of the carotid artery

How is Hardening of the Arteries Treated?

In the early stages of arteriosclerosis, healing is possible, later only the progression can be slowed down.

A drug that dissolves the vascular deposits and fights arteriosclerosis at the roots does not (yet) exist. The following drugs are used in therapy – depending on the risk factors:

Blood Thinners: They are supposed to prevent blood clots from forming in the vessels – and thus prevent heart attacks, strokes and PAD. Doctors use so-called platelet aggregation inhibitors, for example acetylsalicylic acid (ASA).

Lipid lowering Drugs: The aim of the therapy is to lower an elevated cholesterol level. Lipid-lowering agents such as cholesterol synthesis inhibitors (CSE inhibitors, statins) are used; they inhibit the body’s own production of cholesterol in the liver. The concentration of the “bad” LDL cholesterol drops, while the “good” HDL cholesterol rises at the same time. A high level of HDL cholesterol is a protective factor against arteriosclerosis.

Blood pressure Medication: There are a number of medications that lower blood pressure. These include ACE inhibitors, AT1 antagonists, beta blockers, diuretics (water tablets) and calcium antagonists. Which drugs are used varies from person to person.

Antidiabetic Drugs: Here it is important to adjust the blood sugar level well. This can be achieved through antidiabetic drugs and a change in lifestyle. Diabetics have a particularly high risk of arteriosclerosis if, in addition to increased blood sugar, they are also overweight, high blood pressure and a lipid metabolism disorder.

Other Therapies:

  • Lipid Apheresis: It is used in patients who have high levels of LDL cholesterol and lipoprotein a for genetic reasons. Both substances are regularly “washed” from the blood.
  • Surgery: It is used in severe cases, for example when there is a risk of a heart attack or ulcers due to the PAD. The plaques are removed using a catheter (laser, knife) or the vessel is expanded with a small balloon (angioplasty) so that the blood can circulate better. A wire-like braid – the stent – prevents the vessel from narrowing again. In advanced arteriosclerosis, a bypass can help: a “diversion” is placed next to the narrowed vessel. Plaques on the carotid artery (carotid stenosis) can also be surgically removed by scraping.

How can I Prevent Atherosclerosis?

The best way to prevent arteriosclerosis is through a healthy lifestyle or reducing risk factors to a minimum.

What cause Bad breath?

These include a healthy and balanced diet, a normal weight, not smoking, and lots of sport and exercise. Anyone who suffers from diseases such as diabetes, high blood pressure or high cholesterol should receive adequate treatment.

What are the Chances of Recovery From Atherosclerosis?

A healthy lifestyle and the drug treatment of high blood pressure, diabetes and lipid metabolism disorders have a decisive influence on the prognosis of atherosclerosis. The location of the vascular narrowing and the extent of the deposits and vascular changes in the body also play a role. Overall, the earlier the risk factors are minimized, the better the prospects for arteriosclerosis.


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