Atherosclerosis

What is atherosclerosis?

Atherosclerosis is the gradual thickening or hardening of arteries initiated by plaque accumulation along the artery walls. This plaque comprises fatty substances, cholesterol, cellular waste products, calcium, and fibrin. Over time, this buildup leads to arterial walls becoming thickened and inflexible.

Initiating possibly as early as childhood, atherosclerosis is a slow, progressive condition. However, its advancement can accelerate rapidly over time.

What causes atherosclerosis?

Physicians have yet to pinpoint the exact initiation of atherosclerosis. However, it's theorized to commence with damage to the endothelium, the delicate layer of cells lining arteries. This progressive condition may even begin during childhood.

Typical contributors to endothelium damage include:

• Elevated cholesterol levels

• High blood pressure

• Inflammation, such as that seen in arthritis or lupus

• Obesity or diabetes

• Smoking

Symptoms of atherosclerosis

Symptoms of atherosclerosis may not manifest until an artery is significantly narrowed or until a heart attack or stroke occurs. These symptoms can vary depending on the artery affected.

Symptoms associated with coronary arteries include:

• Irregular heartbeat (arrhythmia)

• Pain or pressure in the upper body, including the chest, arms, neck, or jaw (angina)

• Shortness of breath

Symptoms associated with arteries supplying blood to the brain may include:

• Numbness or weakness in the arms or legs

• Difficulty speaking or understanding speech

• Drooping facial muscles

• Paralysis

• Severe headache

• Vision impairment in one or both eyes

Symptoms linked to arteries in the arms, legs, and pelvis include:

• Leg pain during walking, known as intermittent claudication

• Numbness

• Cold feet

• Aching or burning sensation in the toes and feet while at rest

• Persistent foot sores or infections that do not heal

Symptoms associated with the kidneys may include:

• High blood pressure

• Kidney failure

Risk factors of atherosclerosis

Atherosclerosis often begins in youth, with research indicating that even teenagers can exhibit early signs of the condition.

By age 40, if generally healthy, individuals face approximately a 50% likelihood of developing significant atherosclerosis during their lifetime. This risk escalates with age. While most adults over 60 have some degree of atherosclerosis, many do not manifest noticeable symptoms.

Numerous factors contribute to the increased risk of atherosclerosis, with more than 90% of all heart attacks attributed to the following risk factors:

• Abdominal obesity

• Diabetes and insulin resistance

• Family history of heart disease

• High alcohol consumption (exceeding one to two drinks per day, depending on body size)

• Elevated blood pressure

• Elevated LDL cholesterol levels

• Elevated levels of C-reactive protein (CRP) in the blood, indicating inflammation

• High triglyceride levels

• Inadequate consumption of fruits and vegetables

• Lack of regular physical exercise

• Sleep apnoea

• Smoking

• Chronic stress