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Atherosclerosis (also known as Arteriosclerotic Vascular Disease or ASVD) is the condition in which an artery wall thickens as the result of a build-up of fatty materials such as cholesterol. It is a syndrome affecting arterial blood vessels, a chronic inflammatory response in the walls of arteries, in large part due to the accumulation of macrophage white blood cells and promoted by Low-density lipoproteins (plasma proteins that carry cholesterol and triglycerides) without adequate removal of fats and cholesterol from the macrophages by functional high density lipoproteins (HDL). It is commonly referred to as a hardening or furring of the arteries. It is caused by the formation of multiple plaques within the arteries.

Alternative Names of Atherosclerosis are: Arteriosclerosis; Hardening of the arteries; Plaque buildup – arteries.

Complications of Atherosclerosis
The list of complications that have been mentioned in various sources for Atherosclerosis includes:

  • Heart disease
  • Blood clots
  • Angina
  • Heart attack
  • Coronary thrombosis
  • Heart failure
  • Stroke
  • Peripheral vascular disease
  • Leg blood clot
  • Claudication
  • Intermittent claudication
  • Erectile dysfunction

Causes of Atherosclerosis
Why does atherosclerosis occur in the coronary arteries of some people but not others? Interplay of many factors including hypertension (high blood pressure), smoking, diabetes, obesity, high cholesterol, family history of heart disease, and a sedentary lifestyle are involved.

Signs & Symptoms of Atherosclerosis

  • Unfortunately, atherosclerosis produces no symptoms until the damage to the arteries is severe enough to restrict blood flow.
  • Restriction of blood flow to the heart muscle due to atherosclerosis can cause angina pectoris or a myocardial infarction (a heart attack).
  • Restriction of blood flow to the muscles of the legs causes’ intermittent claudication (pains in the legs brought about by walking and relieved by rest).
  • Narrowing of the arteries supplying blood to the brain may cause transient ischemic attacks (symptoms and signs of a stroke lasting less than 24 hours) and episodes of dizziness, or ultimately, to a stroke itself.

Diagnosis of Atherosclerosis

A doctor will perform a physical exam and listen to the heart and lungs with a stethoscope. Early atherosclerosis can create a whooshing or blowing sound ("bruit") over an artery.

Tests that may be used to diagnose atherosclerosis or complications include:

  • Ankle/brachial index (ABI)
  • Aortic arteriography
  • Arteriography
  • Cardiac stress testing
  • Carotid duplex
  • CT scan
  • Doppler study
  • Extremity arteriography
  • Intravascular ultrasound (IVUS)
  • Magnetic resonance arteriography (MRA)
  • Mesenteric arteriography
  • Pulmonary angiography
  • Renal arteriography

Treatments of Atherosclerosis

  • Medication is unsatisfactory for treating atherosclerosis, since the damage has already been done.
  • Anticoagulant drugs have been used to try to minimize secondary clotting and embolus formation.
  • Vasodilator drugs are helpful in providing symptom relief, but are of no curative value.
  • Surgical treatment is available for those unresponsive to medical treatment or in certain high-risk situations.
  • Balloon angioplasty can open up narrowed vessels and promote an improved blood supply.
  • The blood supply to the heart can also be restored by coronary artery bypass surgery.
  • Large atheromatous and calcified arterial obstruction can be removed by endartectomy, and entire segments of diseased peripheral vessels can be replaced by woven plastic tube grafts.

Prevention of Atherosclerosis

The following lifestyle changes can help prevent atherosclerosis:

  • Eat a low-fat, low-cholesterol, and low-salt diet.
  • Eat fish. Adding fish to the diet at least twice a week has been shown to be helpful. Do not fry the fish, as this destroys the benefit.
  • If you don't like to eat fish, try a fish oil supplement.
  • Exercise 30 minutes every day. If you are overweight, you should get 60 - 90 minutes of exercise a day.
  • Lose weight if you are overweight.
  • Stop smoking.
  • Mild to moderate consumption of alcohol or wine (1-2 drinks per day) may also reduce the risk of cardiovascular events. Too much alcohol, however, does more harm than good.
  • If you have one or more risk factors for heart attack or stroke, ask your doctor if you should take aspirin every day. Aspirin can help some people reduce the risk of heart disease and stroke.

Work with your doctor to bring your blood pressure into the normal range. This may require medication. Follow your doctor's recommendations for treating and controlling diabetes and other diseases.

Do not take hormonal replacement therapy, folic acid supplements, vitamin C or E, or antioxidants to decrease the risk of heart disease or stroke. These methods have not been proven to prevent these conditions.

When to seek Medical Advice

  • Call for an appointment with your health care provider if you are at risk for atherosclerosis, especially if symptoms occur.
  • Talk to your doctor before starting a new exercise plan, especially if you have been diagnosed with coronary artery disease or if you have ever had a heart attack.

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