What is Atherosclerosis? | American Heart Association

Atherosclerosis and cholesterol

Plaque (fatty deposits) build up in your arteries is called atherosclerosis. These deposits are made up of cholesterol, fatty substances, cellular waste products, calcium and fibrin (a clotting material in the blood). Atherosclerosis is a type of arteriosclerosis. Arteriosclerosis means hardening (sclerosis) of the arteries.

As plaque builds up, the wall of the blood vessel thickens. This narrows the channel within the artery – reducing blood flow. That lessens the amount of oxygen and other nutrients reaching the body.

Watch an animation about atherosclerosis.

Where plaque develops, and the type of artery affected, varies with each person. Plaque may partially or totally block blood flow through large- or medium-sized arteries in the heart, brain, pelvis, legs, arms or kidneys. This can lead to conditions such as:

• Coronary heart disease (plaque in arteries in or leading to the heart)
• Angina (chest pain from reduced blood flow to the heart muscle)
• Carotid artery disease (plaque in neck arteries supplying blood to the brain)
• Peripheral artery disease, or PAD (plaque in arteries of the extremities, especially the legs)
• Chronic kidney disease

Plaque presents a double threat

Plaque itself can pose a risk. A piece of plaque can break off and be carried by the bloodstream until it gets stuck. And plaque that narrows an artery may lead to a blood clot (thrombus) that sticks to the blood vessel’s inner wall.

In either case, the artery can be blocked, cutting off blood flow.

If the blocked artery supplies the heart or brain, a heart attack or stroke occurs. If an artery supplying oxygen to the extremities (often the legs) is blocked, gangrene, or tissue death, can result.

Atherosclerotic cardiovascular disease (ASCVD) involves plaque buildup in arterial walls which includes conditions such as acute coronary syndrome and peripheral artery disease, and can cause a heart attack, stable or unstable angina, stroke, transient ischemic attack (TIA) or aortic aneurysm.

Download Reduce Your Risk of ASCVD (PDF) | Spanish (PDF)

How it starts and how it progresses

Atherosclerosis is a slow, lifelong progression of changes in the blood vessels that may start in childhood and get worse faster as you age.

The cause of atherosclerosis isn’t completely known.

Many scientists believe plaque begins when an artery’s inner lining (called the endothelium) becomes damaged. Four possible causes of such damage are:

• Elevated levels of cholesterol and triglycerides in the blood
• High blood pressure
• Cigarette smoking
• Diabetes

Smoking plays a big role in the progression of atherosclerosis in the aorta (the body’s main artery), coronary arteries and arteries in the legs. Smoking makes fatty deposits more likely to form, and it accelerates the growth of plaque.

Written by American Heart Association editorial staff and reviewed by science and medicine advisors. See our editorial policies and staff.

Last Reviewed: Nov 6, 2020

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Atherosclerosis is a disease in which plaque builds up inside your arteries. Plaque is a sticky substance made up of fat, cholesterol, calcium, and other substances found in the blood. Over time, plaque hardens and narrows your arteries. That limits the flow of oxygen-rich blood to your body.

Atherosclerosis can lead to serious problems, including:

• Coronary artery disease. These arteries supply blood to your heart. When they are blocked, you can suffer angina or a heart attack.
• Carotid artery disease. These arteries supply blood to your brain. When they are blocked you can suffer a stroke.
• Peripheral arterial disease. These arteries are in your arms, legs and pelvis. When they are blocked, you can suffer from numbness, pain and sometimes infections.

Atherosclerosis usually doesn’t cause symptoms until it severely narrows or totally blocks an artery. Many people don’t know they have it until they have a medical emergency.

A physical exam, imaging, and other diagnostic tests can tell if you have it. Medicines can slow the progress of plaque buildup. Your doctor may also recommend procedures such as angioplasty to open the arteries, or surgery on the coronary or carotid arteries. Lifestyle changes can also help. These include following a healthy diet, getting regular exercise, maintaining a healthy weight, quitting smoking, and managing stress.

NIH: National Heart, Lung, and Blood Institute

• What Is Atherosclerosis?

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• Angioplasty: MedlinePlus Health Topic

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• Chelation for Coronary Heart Disease

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• Heart-Healthy Diet: Eight Steps to Prevent Heart Disease

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• Atherosclerosis and Stroke

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• Cerebral Arteriosclerosis

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• ClinicalTrials. gov: Arteriosclerosis

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• ClinicalTrials.gov: Atherosclerosis

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Peripheral arterial disease – what is it?

25. 10.2019

Atherosclerosis (hardening arteries ) is a disease caused by narrowing and closing of the limbs arteries .

Causes of peripheral arterial disease

Hardening of the arteries begins with minor injuries to the innermost layer of the artery . Various substances accumulate in the area of ​​damage. This deposit in the long run will lead to a narrowing of vessels until the closure of blood vessels .

Many factors contribute to the development of vessel calcification .

Prolonged high blood pressure is one of the most common causes of atherosclerosis because it can lead to injury to the wall of the artery . With diabetes mellitus vascular attacks often occur already at a fairly young age. Age plays a big role. Because with age there is a loss of elasticity vessels , as the elastic fibers disappear and are replaced by “hard” connective tissue. Elevated blood fats increase the risk of hardening arteries because fat is deposited in vessels . Also, smoking harms vessels in the long term.

All arteries of the body can be narrowed by atherosclerotic changes. In peripheral arterial disease, the pelvic and leg arteries are usually affected . One narrowing of arteries is an absolute rarity.

Symptoms

A typical symptom is the so-called “showcase disease”: from a certain walking distance, victims notice pain in their legs which makes them stand. After a short break, the discomfort subsides and the victim continues to work. So that this strange rhythm is not too noticeable, people like to stand in front of shop windows.

The cause of these ailments is the lack of oxygen in the muscles as a result of poor blood circulation. The meaning of pain depends on the location of the narrowing vessels . As a rule, discomfort is always felt below the affected artery .

Course and complications

If the disease progresses, leg pain also occurs at rest. If the artery is completely closed, the deficient tissue dies. The most common location for these dead tissues is toes . Talk about necrosis or gangrene. With dry gangrene, the black area has a mummified appearance, with wet gangrene, on the contrary, tissue breakdown due to bacterial decomposition is used, an unpleasant odor is typical.

Especially in the aorta, the largest artery of our body, over the years a cluster can form, the so-called aneurysm . If the size of this package increases, there is a risk of it breaking.

Fear of acute arterial insufficiency caused by free parts of vascular deposits. They continue to be transported with blood until they get stuck in small vessels and completely clog them.

Clinical pictures with similar symptoms

Discomfort in the legs also occurs with chronic weakness veins , or their result, varicose veins . However, this affects the veins , ie the blood vessels , which transport the blood consumed back to the heart . Arterial disease affects the blood vessels that carry oxygen-rich blood to feet .

Pain in the legs that occurs during exercise can also be a sign of damage to the intervertebral disc .

In the context of nerve damage, polyneuropathy, pain in the leg often occurs.

In severe pain, especially in the big toe , one should think of an acute attack of gout.

Treatment

Above all, avoid risk factors to prevent the progression of arterial disease. This means you need treat high blood pressure , diabetes and elevated blood fats . Give up nicotine. To prevent hardening of the arteries , a balanced and low-fat diet , as well as regular exercise, is important. In the initial stage of peripheral VKA, walking is an important measure: the victim should continue walking until pain appears, and then stop and continue work until discomfort improves. The purpose of this therapy is the promotion of bypass circles in the area of ​​constricted blood vessels . Achievements can be achieved by daily training 1-2 hours. Important: well-fitting and comfortable shoes and careful care of feet . In this way, injuries that heal very slowly due to poor circulation can be avoided. Menopausal baths with cold and warm water can stimulate circulation.

In any case, be sure to come to the reception to doctor to exclude other diseases and not to attribute treatment from unknown sources.

Published in Cardiology Premium Clinic

Publication date: November 2, 2017
Update date: December 01, 2021

What is atherosclerosis and how to detect this disease in advance?

Atherosclerosis is a real executioner of the modern world. According to various data, mortality due to cardiovascular pathology associated with atherosclerosis reaches 85% of the total number of deaths in the world. With the greatest frequency, atherosclerosis affects men older than 45-50 years (3-4 times more often than women), but occurs in younger patients.

Atherosclerosis (translated from the Greek athera-gruel + sklerosis-hardening) is a lesion of the arteries, accompanied by cholesterol deposits in the inner membranes of the vessels, narrowing of their lumen and malnutrition of the blood-supplying organ.

The composition of cholesterol deposits includes those very “bad” fats – cholesterol and some fractions of lipoproteins that enter our bloodstream through food saturated with fatty acids – mainly fatty meat products. Deposits form in the form of atheromatous plaques. The subsequent proliferation of connective tissue in them and the inclusion of calcium lead to deformation and narrowing of the lumen up to blockage of the vessel. All types of cholesterol deposits, starting from the very first, the so-called lipid spots, can be traced with ultrasound.

At the moment, there is no unified theory of the occurrence of this disease. The most famous theory is lipoprotein infiltration, in which there is a primary accumulation of “bad” fats in the vascular wall.

There are opinions that infectious agents (herpes simplex virus, cytomegalovirus, chlamydial infection, etc.), a violation of the protective properties of the endothelium and its mediators, hereditary diseases accompanied by an increase in cholesterol levels, autoimmune causes, mutations of cells of the vascular walls play a role in the development of atherosclerosis. There is also a hormonal theory, according to which an age-related increase in the level of gonadotropic and adrenocorticotropic hormones leads to an increased synthesis of the building material for cholesterol hormones.

Risk factors that aggravate the prognosis of the course and development of atherosclerosis:

– smoking (the most dangerous factor)

– hyperlipoproteinemia (total cholesterol > 5 mmol/l, LDL > 3 mmol/l, Lp(a) > 50 mg/dl)

– arterial hypertension (systolic blood pressure > 140 mm Hg diastolic blood pressure > 90 mm Hg)

– diabetes

– obesity

– sedentary lifestyle (lack of exercise)

– emotional stress

– malnutrition

– hereditary predisposition

– postmenopause

– hyperfibrinogenemia

– homocysteinuria

– hypothyroidism

Which arteries can be affected by atherosclerosis and what does it lead to?

Damage to the arteries of the heart, or coronary arteries, leads to the development of coronary heart disease, which leads to the development of myocardial infarction.

Damage to the arteries of the neck leads to the development of a stroke.

Damage to the arteries that feed the digestive organs (intestines, stomach) leads to the development of ischemia of the digestive organs.

The defeat of the renal arteries leads to a reflex increase in blood pressure, developing renovascular hypertension.

Damage to the arteries of the lower extremities leads to the development of intermittent claudication or the “poster” syndrome, pain in the muscles of the lower leg appears during walking, forcing to stop, supposedly to read advertising posters. And in the last stages, gangrene develops, which can lead to amputation of the limb.

So, atherosclerotic lesion of the arteries is a multifaceted process that affects all organs and systems of our body!

In order to prevent these serious, life-threatening diseases, it is necessary to constantly be monitored by specialist doctors, annually take a minimum range of tests, including lipidogram and coagulogram, follow dietary recommendations and all medical prescriptions.