Atherosclerosis: Symptoms, Causes, & Treatment

The main function of red blood cells is to carry oxygen from the lungs to other tissues in the body, where it is converted into energy so the body can function. After delivering oxygen to different parts of the body, the red blood cells will return to the heart carrying carbon dioxide that is then pumped into the lungs, so you can breathe it out.

The process, which is referred to as the circulatory system, is highly dependent on the red blood cells moving freely in the arteries and veins, delivering oxygen or removing carbon dioxide so the body stays healthy, and so organs and muscles function properly. Plaque, made up of cholesterol, can build up in the arteries over time and restrict the essential flow of red blood cells so that oxygen does not get to where it is needed. This condition is called atherosclerosis and can lead to life-threatening diseases that affect the heart and even the brain. 

Atherosclerosis is a condition that happens when arteries become narrow and hard because of plaque building up along the lining of the artery walls. In addition to cholesterol, plaque can also be created by calcium and fats, and can even break apart in the blood vessels causing a blood clot. 

Coronary atherosclerosis refers to arteries becoming stiff and narrow near the heart leading to different heart conditions. While the condition of arteries leading to the brain becoming narrowed or blocked is called cerebral atherosclerosis. 

What are the four stages of atherosclerosis? There are four recognized stages of this condition with the first stage exhibiting no plaque and is referred to as a healthy blood vessel. The other three stages organized in order of severity starting with the least are:

• Fatty streak
• Fibrofatty plaque
• Complicated plaques

Although the two terms, atherosclerosis and arteriosclerosis look similar and may even be used interchangeably, they are not exactly the same. Arteriosclerosis is an umbrella term for several conditions that involve arteries becoming stiff and thick. Atherosclerosis, on the other hand,  falls under this overarching term and refers to arteries that are stiff and thick specifically caused by plaque buildup. 

As the arteries narrow, the risk of a blood clot increases. When an artery is completely blocked, the first obvious symptom of atherosclerosis is often a major health event like a stroke or heart attack. Depending on where the blockage occurs and what major organ is located nearest to the blocked artery, symptoms can include:

• Chest pain
• Pain in a specific extremity
• Shortness of breath
• Becoming lightheaded or dizzy
• Confusion
• Arrhythmia or an unusual heartbeat
• Numbness
• Aneurism
• Drooping facial muscles
• Severe headache

What is the most common symptom of atherosclerosis? While symptoms vary depending on where in the body the blockage occurs, one common symptom after the blood vessel is blocked is sudden, inexplicable pain near the site of the clogged artery. 

Age plays a big role in the development of atherosclerotic disease as well as other arteriosclerotic conditions. As a person gets older their arteries lose their elasticity which causes them to become stiff. In atherosclerosis, if the inside of the artery, called the endothelium, becomes damaged, cholesterol in the bloodstream enters the artery wall and essentially gets caught there, developing plaque buildup over time. Conditions that can result in atherosclerosis are:

• Diabetes
• High blood pressure
• Stress
• High cholesterol
• Obesity
• Smoking 

What is the main cause of atherosclerosis? While plaque is literally the cause of atherosclerosis and the blockage of arteries, knowing exactly why plaque builds up in the blood vessels is not completely clear. The above causes contribute greatly to the likelihood of developing damage to the internal artery walls where plaque begins to build up, layer by layer over time.

Periodontal disease could also contribute to atherosclerosis from certain types of bacteria that enter the bloodstream through chronically inflamed gums that can ultimately cause inflammation that begins to trap plaque along the artery wall. 

 

There are many different ways to check for signs of atherosclerosis. Your doctor will start off with a physical exam by listening to your heart or arteries for an unusual whooshing sound called a bruit, look for signs of weak pulse, and ask you about signs of slow wound healing, which can indicate low blood flow. If all signs continue to point to atherosclerosis being a possibility, your doctor will put you through a series of tests to help identify where the problem is to give a complete diagnosis.

Tests include:

• A stress test
• Blood tests for high cholesterol or blood sugar
• Different artery scans to look for blockage and hardening of the arteries  are:
  • Angiogram
  • CT scan
  • Magnetic resonance angiography
  • Doppler ultrasound
• Ankle-brachial index that compares blood pressure taken in different extremities
• EKG

The best aspect of being diagnosed with atherosclerosis is that a person can act on this new awareness by changing lifestyle habits to get healthy and can now be properly treated instead of realizing there is an issue after a major medical event takes place. Once a person is diagnosed with atherosclerosis, simply removing the current plaque in arteries is not easy and is only attempted if the blockage is severe. The main treatment focus is on slowing down the growth of the plaque. The first line of treatment is lifestyle changes. 

• Exercise will strengthen your arteries
• Diet changes that increase healthy vegetables and are low in fat, sugar, and sodium
• Quit smoking

Medications can also slow down and potentially stop the plaque from causing a greater blockage in the artery by treating high blood pressure or high cholesterol. Aspirin can be used to help the blood from clotting.

If more intervention is needed, surgery is also an option to alleviate plaque-clogged arteries. 

• By-pass surgery can be done by taking a blood vessel from another part of your body to create a new pathway around a blockage.
• Endarterectomy is the removal of plaque that builds up in your neck arteries.
• A stent can be inserted in a blocked artery to keep it open, allowing the oxygen-filled red blood cells to flow through freely.
• Thrombolytic or fibrinolytic therapies use drugs to dissolve blood clots in the arteries. 

As stated before, the older you are, the more likely you will have some sort of atherosclerosis, significantly starting at the age of 40. If you are in good health, you still have about a 50% chance of developing serious atherosclerosis in your lifetime. As you age past 40 years old, the atherosclerosis risk factors increase. Other contributors to the development of atherosclerosis are:

• Family history
• Obesity- particularly abdominal obesity
• Diabetes
• Poor lifestyle choices like
  • Consuming more than one alcoholic beverage a day
  • Not eating fruits and vegetables
  • Smoking
  • Not exercising regularly
• High cholesterol
• High blood pressure
• Stress

Depending on where the blocked artery is located in the body, complications from atherosclerosis can affect the heart, brain, or even an extremity like an arm or leg. Possible cardiovascular disease complications from atherosclerosis include:

• Coronary artery disease can lead to heart attack, heart failure, angina, and unusual heart rhythms. 
• Cerebrovascular disease leads to stroke, permanent brain damage, sight and speech disruptions, and paralysis.
• Peripheral artery disease can lead to numbness, pain when walking, and even loss of limb. 

Kidney failure is also a complication associated with atherosclerosis.

Positive lifestyle changes can have a huge impact on your overall health, including preventing atherosclerosis from becoming severe enough to cause complications. Diet and exercise play an important role in health to keep arteries and muscles strong while providing the necessary nutrients so that our bodies function properly.

• Replacing red meat a few times a week for omega-3-rich meats like fish will benefit your health.
• Avoid fatty foods and saturated fats. 
• Up the leafy green vegetables in your diet to increase your vitamin K consumption, which can keep your arteries healthy, avoiding damage. A study shows dietary nitrate-rich foods like kale, spinach, and collard greens can reduce blood pressure and improve blood vessel function.
• Increasing antioxidant fruits like berries in your diet has been shown to significantly decrease harmful low-density lipoproteins, often called bad cholesterol.

Exerting your body through workouts, even walking, for a solid 20 minutes a day will benefit your health. You will strengthen your blood vessels and your heart by exercising. Working out increases your endorphins and reduces harmful stress, which can also lead to atherosclerosis.

Though more studies need to be done to document the effectiveness of supplements to help treat atherosclerosis, there has been evidence that some vitamins and foods can aid in lowering the chances of developing this condition.

• Niacin is a supplement that can aid people with heart disease and has positive effects on blood clotting. 
• Black tea can aid in high blood pressure and has antioxidants that can help protect blood vessels. 
• Alpha-linoleic acid, which is a form of Omega fatty acid, can help maintain a normal heartbeat and can be found in walnuts.  
• Garlic can help lower high blood pressure.  

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