What is atherosclerosis?
Atherosclerosis is a condition in which fatty deposits, known as plaque or atheroma, build up within the walls of the arteries. Over time, these deposits of plaque may become larger, narrowing the arteries and restricting blood flow to certain organs.
Atherosclerosis is related to a number of cardiovascular conditions, including coronary heart disease and stroke. There are a variety of risk factors associated with the condition, with some of the most common including high cholesterol levels, high blood pressure, diabetes, smoking and obesity.
Although atherosclerosis is a potentially serious condition, it can be managed through lifestyle changes and treatment of its underlying causes.
Atherosclerosis is a specific variety of arteriosclerosis, though the two terms are sometimes used interchangeably. Arteriosclerosis refers to a hardening and loss of elasticity in the arteries, which can lead to the same complications as those associated with atherosclerosis.
Causes of atherosclerosis
Atherosclerosis is caused by a buildup of plaque in the artery walls (endothelium). Plaque is composed of calcium, cholesterol, fats and other substances found in the blood. If it hardens, plaque can block the arteries and restrict blood flow.
A number of pre-existing conditions, lifestyle choices and other factors can make atherosclerosis more likely. The most common of these include:
- High cholesterol levels
- High blood pressure
- Lack of physical activity
- Unhealthy diet (high in salt, sugar, fats and cholesterol)
- Family history of cardiovascular disease
- Alcohol consumption
Conditions associated with atherosclerosis
Atherosclerosis may partially, or totally, block the arteries in the heart, brain, legs, arms, pelvis or kidneys. If this occurs, various conditions can result. These include:
A buildup of plaque in the coronary arteries, which supply oxygen-enriched blood to the heart, can lead to coronary artery disease. This may cause narrowing of the arteries, which restricts blood flow to the heart and increases the likelihood of a buildup of blood clots in the artery walls, potentially leading to complications such as heart attacks. Coronary artery disease is the most common condition associated with atherosclerosis and is a leading cause of mortality in the USA.
Coronary artery disease can also lead to angina – feelings of pain, squeezing or tightening in the chest. Angina can, in many cases, act as a warning sign for a possible heart attack.
Atherosclerosis can lead to a range of cerebrovascular conditions, including stroke and transient ischemic attack, sometimes called a mini-stroke. These conditions occur when plaque builds up in the arteries leading to the brain, restricting blood flow and starving the brain of oxygen.
Peripheral arterial disease
Peripheral arterial disease generally refers to a narrowing of the arteries in any location other than the heart or brain, with the legs being the most commonly affected area. Atherosclerosis is one of the main causes of this condition. When affecting the legs, peripheral arterial disease is characterized by pain in the calves, especially when walking or exercising.
Vascular dementia is a condition that results in memory loss, thinking problems and issues with language as a result of a reduced supply of blood to the brain. Along with Alzheimer’s disease, vascular dementia is one of the most common types of dementia.
Chronic kidney disease
Chronic kidney disease develops when the kidneys become unable to perform properly their function of filtering excess water and other waste products from the blood. A buildup of plaque in the arteries of the kidneys can cause chronic kidney disease, which can eventually lead to kidney failure.
Atherosclerosis is among the leading causes of erectile dysfunction, the condition of being unable to get or maintain an erection. An erection is caused by a rush of blood to the penis. When the blood vessels in the penis begin to narrow, blood flow is restricted, causing erectile dysfunction.
Diagnosing atherosclerosis will generally involve a doctor looking at an individual’s medical history, a physical examination and a range of tests.
During the physical examination, a stethoscope will normally be used to listen to the individual’s heartbeat and blood flow in the vessels. The medical professional will take special care to listen for sounds that indicate the narrowing of the blood vessels, which can often indicate the presence of plaque and clogged arteries.
Tests that may aid a diagnosis of atherosclerosis include:
- Blood pressure measurement: A doctor will check whether the readings are out of range.
- Blood tests: To check the levels of fats, sugars, cholesterol and protein in the blood.
- Electrocardiogram (EKG): A method for testing the electrical activity of the heart.
- Chest X-ray: An image of the organs and blood vessels within the chest is taken, allowing doctors to check for abnormalities.
- Echocardiography: An ultrasound is used to create an image of the heart. This can give doctors a holistic picture of the heart’s health.
- Computed tomography (CT) scan: A computer-generated image of the body is created, allowing doctors to see signs of artery narrowing or hardening.
- Angiography: A contrast dye is injected into specific blood vessels, which can then be visualized by X-ray. Catheters are often used. This test allows doctors to see signs of atherosclerosis.
At present, no treatment exists to reverse atherosclerosis. However, there are a variety of ways to slow the progress of the condition and reduce the risk of complications, such as heart attack and stroke. These include:
- Lifestyle changes that are also used to help prevent atherosclerosis (see below)
- Statins and other medications used to treat high cholesterol
- Medications used to treat high blood pressure
- Low-dose aspirin and other medications used to treat blood clots
- Medications for diabetes
- Surgical procedures to bypass or widen an artery, such as a coronary artery bypass graft or coronary angioplasty
A doctor will be able to advise on the treatment options available in each case. Doctors can also recommend lifestyle changes that may help manage the condition.
As there is no direct treatment for atherosclerosis, health care professionals place emphasis on methods of preventing the condition from developing. These preventive methods include:
- Stopping smoking
- Getting regular exercise
- Eating a healthy, balanced diet
- Maintaining a healthy weight
- Avoiding alcohol
A doctor will be able to advise on the best methods of pursuing these lifestyle changes.
Q: Is atherosclerosis of the aorta possible?
A: Yes, plaque deposits can form in the aorta, causing atherosclerosis. Aortic atherosclerosis can cause an aortic aneurysm and increase the risk of stroke.
Q: What is atherosclerotic calcification?
A: The plaque that builds up as a result of atherosclerosis generally contains traces of calcium. Atherosclerotic calcification refers to the process of calcium buildup, which is of particular interest to doctors and scientists due to its similarity to the process of bone formation.
Q: What is the difference between atherosclerosis and arteriosclerosis?
A: Atherosclerosis is a specific variety of arteriosclerosis, though the two terms are sometimes used interchangeably. Arteriosclerosis refers to a hardening and loss of elasticity in the arteries, which can be caused by atherosclerosis or other conditions.
American Heart Association. “Coronary Artery Disease - Coronary Heart Disease.” April 26, 2017. Accessed April 8, 2018. ↩
National Institute of Diabetes and Digestive and Kidney Diseases. “Questions and Answers About Kidneys and Kidney Disease.” March 1, 2012. Accessed August 29, 2017. ↩
NCBI. “Calcification in atherosclerosis: Bone biology and chronic inflammation at the arterial crossroads.” September 19, 2003. Accessed August 29, 2017. ↩