Atherosclerosis is a narrowing of the arteries caused by a buildup of plaque. Arteries are the blood vessels that carry oxygen and nutrients from your heart to the rest of your body.
As you get older, fats, cholesterol, and calcium can collect in your arteries and form plaque. The buildup of plaque makes it difficult for blood to flow through your arteries. This buildup may occur in any artery in your body, including around your heart, legs, brain, and kidneys.
Mild atherosclerosis usually doesn’t have any symptoms. You usually won’t have atherosclerosis symptoms until an artery is so narrowed or clogged that it can’t supply enough blood to your organs and tissues. Sometimes a blood clot completely blocks blood flow, or even breaks apart and can trigger a heart attack or stroke.
Symptoms of moderate to severe atherosclerosis depend on which arteries are affected. For example:
• If you have atherosclerosis in your heart arteries, you may have symptoms, such as chest pain or pressure (angina).
• If you have atherosclerosis in the arteries leading to your brain, you may have signs and symptoms such as sudden numbness or weakness in your arms or legs, difficulty speaking or slurred speech, temporary loss of vision in one eye, or drooping muscles in your face. These signal a transient ischemic attack (TIA), which, if left untreated, may progress to a stroke.
• If you have atherosclerosis in the arteries in your arms and legs, you may have signs or symptoms of peripheral artery disease, such as leg pain when walking (claudication) or decreased blood pressure in an affected limb.
• If you have atherosclerosis in the arteries leading to your kidneys, you develop high blood pressure or kidney failure.
There are several stages of atherosclerosis. Each stage involves changes in your artery wall. These changes are so tiny that you can’t see most of them without a microscope. But they add up to cause serious damage to your artery.
▪︎ Endothelial damage and immune response
Atherosclerosis begins when damage occurs to the inner layer of your artery wall. This layer is called the intima. The surface of your intima is lined with endothelial cells. This thin lining, called the endothelium, is the barrier between your blood and your artery wall.
Many things can harm your endothelium. The most common culprits include:
• High levels of LDL (“bad”) cholesterol circulating in your blood.
• Toxins, like those from cigarette smoke.
• High blood pressure that persists for a long time.
▪︎ Fatty streak
A “fatty streak” is the first visible sign of atherosclerosis. It’s a yellow streak or patch formed from dead cells at the site of endothelial damage.
All the dead foam cells form a bulge underneath your endothelium. This “fatty streak” is the beginning of plaque formation.
▪︎ Plaque growth
More dead foam cells and other debris continue building up at the site of the fatty streak. The fatty streak slowly gets bigger and forms into a larger piece of plaque. Your artery’s smooth muscle cells form a layer on top of this plaque. This is called a fibrous cap. The fibrous cap covers the plaque. It prevents bits of plaque from breaking off into your bloodstream. Meanwhile, the plaque keeps growing. It gains calcium, which makes it harder.
For a while, your blood still has enough room to pass through. That’s because your artery wall expands outward to make space for the plaque. But it can only expand outward so far. As the plaque gets too big, the opening of your artery becomes narrower and narrower. There’s less room for your blood to flow through. The plaque may stay stable for a long time. But eventually, it can rupture.
▪︎ Plaque rupture
In this final stage, the plaque ruptures and causes major problems in your body. At this point, the plaque has been in your artery for a long time — perhaps many years. It has grown in size and taken up more space in your artery. But the fibrous cap has kept the plaque from breaking open until this point.
When the fibrous cap breaks open, the plaque inside comes into contact with your blood. This can trigger a blood clot to form. This blood clot (known as a “thrombus”) blocks your blood flow and leads to a heart attack or stroke.
Arteries carry blood from the heart to the rest of the body. A thin layer of cells forms a lining that keeps them smooth and allows blood to flow easily. This is called the endothelium. Atherosclerosis happens when the endothelium becomes damaged, due to factors such as smoking, high blood pressure, or high levels of glucose, fat, and cholesterol in the blood.
This damage allows a collection of substances, known as plaque, to build up in the artery wall. These substances include fat and cholesterol. Over time, plaque can build up and become hard. If plaque continues to collect, it can block the artery and disrupt the flow of blood around the body.
Sometimes, pieces of plaque break open. If this happens, particles from blood cells, known as platelets, gather in the affected area. These can stick together, forming blood clots. A clot can block the artery, leading to life threatening complications, such as stroke and heart attack.
What’s the difference between atherosclerosis and arteriosclerosis?
Atherosclerosis is a type of arteriosclerosis, which is any hardening of the arteries. Your arteries can become hard or stiff for many different reasons. One reason is plaque buildup. That’s what atherosclerosis refers to. But the two terms are often used to mean the same thing.
Risk Factors –
Hardening of the arteries occurs over time. Besides aging, factors that may increase your risk of atherosclerosis include:
• High blood pressure
• High cholesterol
• High levels of C-reactive protein (CRP), a marker of inflammation
• Sleep apnea
• Smoking and other tobacco use
• A family history of early heart disease
• Lack of exercise
• An unhealthy diet
The complications of atherosclerosis include:
• heart disease, heart attack, or heart failure
• peripheral artery disease
• kidney failure
• irregular heart rhythms and palpitations
• embolism when a piece of the clot breaks off and travels to another part of the bloodstream
Your doctor will start with a physical exam. They’ll listen to your arteries and check for weak or absent pulses.
You might need tests, including:
• Angiogram, in which your doctor puts dye into your arteries so they’ll be visible on an X-ray
• Ankle-brachial index, a test to compare blood pressures in your lower leg and arm
• Blood tests to look for things that raise your risk of having atherosclerosis, like high cholesterol or blood sugar
• CT scan or magnetic resonance angiography (MRA) to look for hardened or narrowed arteries
• EKG, a record of your heart’s electrical activity
• Stress test, in which you exercise while health care professionals watch your heart rate, blood pressure, and breathing
Lifestyle changes, such as eating a healthy diet and exercising, are the first treatment for atherosclerosis — and may be all that you need to treat your atherosclerosis. But sometimes, medication or surgical procedures may be needed.
Many different drugs are available to slow — or even reverse — the effects of atherosclerosis. Here are some medications used to treat atherosclerosis:
• Statins and other cholesterol medications.
Aggressively lowering your low-density lipoprotein (LDL) cholesterol — the bad cholesterol — can slow, stop or even reverse the buildup of fatty deposits in your arteries.
Statins are commonly prescribed to lower cholesterol, improve artery health and prevent atherosclerosis. There are many other types of cholesterol-lowering medications.
• Blood thinners.
Your doctor may prescribe blood-thinning medications, such as aspirin, to reduce your risk that platelets will clump in narrowed arteries, form a blood clot and cause further blockage.
• Blood pressure medications.
Drugs to lower blood pressure don’t help reverse atherosclerosis but instead prevent or treat complications related to the disease.
• Other medications.
Your doctor may prescribe other medications to control health conditions that raise your risk of atherosclerosis, such as diabetes. And, specific medications to treat symptoms of atherosclerosis, such as leg pain during exercise, may be prescribed.
▪︎ Surgery or other procedures
Sometimes more aggressive treatment is needed to treat atherosclerosis. If you have severe symptoms or a blockage, your doctor may recommend one of the following surgical procedures:
• Angioplasty and stent placement.
• Fibrinolytic therapy.
• Coronary artery bypass surgery.
Ayurvedic Perspective –
Ayurveda classifies Atherosclerosis as Sanga or Dhamni Pratichaya which is a disorder of Kapha origin affecting Vyana Vayu in Raktavaha Srotas. The causative factor being Kapha affects meda dhatu-adipose tissue, particularly the Meda dhatu agni-metabolism at the level of adipose tissue.
▪︎ Some Beneficial Herbs
The same healthy lifestyle changes recommended to treat atherosclerosis also help prevent it. These include:
• Quitting smoking
• Eating healthy foods
• Exercising regularly
• Maintaining a healthy weight
• Checking and maintaining a healthy blood pressure
• Checking and maintaining healthy cholesterol and blood sugar levels
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