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What Is Atherosclerosis?Atherosclerosis (ath-er-o-skler-O-sis) is a disease in which plaque (plak) builds up inside your arteries.Arteries are blood vessels that carry oxygen-rich blood to your heart and other parts of your body.Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. Over time,plaque hardens and narrows your arteries. This limits the flow of oxygen-rich blood to your organs andother parts of your body.Atherosclerosis can lead to serious problems, including heart attack, stroke, or even death. Atherosclerosis Figure A shows a normal artery with normal blood flow. Figure B shows an artery with plaque buildup.
What Causes Atherosclerosis?Atherosclerosis starts when high blood pressure, smoking, or high cholesteroldamage the endothelium. Atthat point, cholesterol plaque formation begins.Cholesterol invasion. Bad cholesterol, or LDL, crosses damaged endothelium. The cholesterol enters thewall of the artery.Plaque formation. Your white blood cells stream in to digest the LDL cholesterol. Over years, theaccumulating mess of cholesterol and cells becomes a plaque in the wall of the artery.Atherosclerosis tends to happen throughout the body. "So if you have plaque in your heart, youre at ahigher risk for stroke, and vice versa," says Stein.Atherosclerosis usually causes no symptoms until middle or older age. Once narrowings become severe,they choke off blood flow and can cause pain. Blockages can also suddenly rupture, causing blood to clotinside an artery at the site of the rupture.Atherosclerosis-Related DiseasesAtherosclerosis can affect any artery in the body, including arteries in the heart, brain, arms, legs,pelvis, and kidneys. As a result, different diseases may develop based on which arteries are affected.Coronary Heart DiseaseCoronary heart disease (CHD), also called coronary artery disease, is the #1 killer of both men andwomen in the United States. CHD occurs if plaque builds up in the coronary arteries. These arteriessupply oxygen-rich blood to your heart.Plaque narrows the coronary arteries and reduces blood flow to your heart muscle. Plaque buildup alsomakes it more likely that blood clots will form in your arteries. Blood clots can partially or completelyblock blood flow.If blood flow to your heart muscle is reduced or blocked, you may have angina(chest pain ordiscomfort) or a heart attack.Plaque also can form in the hearts smallest arteries. This disease is calledcoronary microvasculardisease (MVD). In coronary MVD, plaque doesnt cause blockages in the arteries as it does in CHD.Carotid Artery DiseaseCarotid (ka-ROT-id) artery disease occurs if plaque builds up in the arteries on each side of your neck(the carotid arteries). These arteries supply oxygen-rich blood to your brain. If blood flow to yourbrain is reduced or blocked, you may have a stroke.
Peripheral Arterial DiseasePeripheral arterial disease (P.A.D.) occurs if plaque builds up in the major arteries that supply oxygen-rich blood to your legs, arms, and pelvis.If blood flow to these parts of your body is reduced or blocked, you may have numbness, pain, and,sometimes, dangerous infections.Chronic Kidney DiseaseChronic kidney disease can occur if plaque builds up in the renal arteries. These arteries supplyoxygen-rich blood to your kidneys.Over time, chronic kidney disease causes a slow loss of kidney function. The main function of thekidneys is to remove waste and extra water from the body.Atherosclerosis PreventionAtherosclerosis is progressive, but its also preventable. For example, nine risk factors are to blame for upto 90% of all heart attacks:SmokingHigh cholesterolHigh blood pressureDiabetesAbdominal obesity ("spare tire")StressNot eating fruits and vegetablesExcess alcohol intake (more than one drink for women, one or two drinks for men, per day)Not exercising regularlyAtherosclerosis TreatmentOnce a blockage is there, its generally there to stay. With medication and lifestyle changes, though,plaques may slow or stop growing. They may even shrink slightly with aggressive treatment.Lifestyle changes: Reducing the lifestyle risk factors that lead to atherosclerosis will slow or stop theprocess. That means a healthy diet, exercise, and no smoking. These lifestyle changes wont removeblockages, but they’re proven to lower the risk of heart attacks and strokes.Medication:Taking drugs for high cholesterol and high blood pressure will slow and perhaps even haltthe progression of atherosclerosis, as well as lower your risk of heart attacks and stroke.Using invasive techniques, doctors can also open up blockages from atherosclerosis, or go around them:Angiography and stenting: Cardiac catheterization with angiography of the coronary arteries is themost common angiography procedure performed. Using a thin tube inserted into an artery in the leg or
arm, doctors can access diseased arteries. Blockages are visible on a live X-ray screen. Angioplasty(catheters with balloon tips) and stenting can often open up a blocked artery.Bypass surgery: Surgeons "harvest" a healthy blood vessel (often from the leg or chest). They use thehealthy vessel to bypass a segment blocked by atherosclerosis.These procedures involve a risk of complications. They are usually saved for people with significantsymptoms or limitations caused by atherosclerosis.