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Arteriosclerosis occurs when the blood vessels that carry oxygen and nutrients from your heart to the rest of your body (arteries) become thick and stiff — sometimes restricting blood flow to your organs and tissues such as penis and brain. Healthy arteries are flexible and elastic, but over time, the walls in your arteries can harden, a condition commonly called hardening of the arteries.
Atherosclerosis is a specific type of arteriosclerosis, but the terms are sometimes used interchangeably. Atherosclerosis refers to the buildup of fats, cholesterol and other substances in and on your artery walls (plaques), which can restrict blood flow.
These plaques can burst, triggering a blood clot. Although atherosclerosis is often considered a heart problem, it can affect arteries anywhere in your body. Atherosclerosis usually is preventable and is treatable.
Atherosclerosis develops gradually. 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 adequate 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 think you have atherosclerosis, talk to your doctor. Also pay attention to early symptoms of inadequate blood flow, such as chest pain (angina), leg pain or numbness. Early diagnosis and treatment can stop atherosclerosis from worsening and prevent a heart attack, stroke or another medical emergency.
Atherosclerosis is a slow, progressive disease that may begin as early as childhood. Although the exact cause is unknown, atherosclerosis may start with damage or injury to the inner layer of an artery. The damage may be caused by:
Once the inner wall of an artery is damaged, blood cells and other substances often clump at the injury site and build up in the inner lining of the artery. Over time, fatty deposits (plaques) made of cholesterol and other cellular products also build up at the injury site and harden, narrowing your arteries. The organs and tissues connected to the blocked arteries then don't receive enough blood to function properly.
Eventually pieces of the fatty deposits may break off and enter your bloodstream. In addition, the smooth lining of a plaque may rupture, spilling cholesterol and other substances into your bloodstream. This may cause a blood clot, which can block the blood flow to a specific part of your body, such as occurs when blocked blood flow to your heart causes a heart attack. A blood clot can also travel to other parts of your body, blocking flow to another organ.
Hardening of the arteries occurs over time. Besides aging, factors that increase the risk of atherosclerosis include:
The complications of atherosclerosis depend on which arteries are blocked. For example:
When atherosclerosis narrows the arteries close to your heart, you may develop coronary artery disease, which can cause chest pain (angina), a heart attack or heart failure.
When atherosclerosis narrows the arteries close to your brain, you may develop carotid artery disease, which can cause a transient ischemic attack (TIA) or stroke.
When atherosclerosis narrows the arteries in your arms or legs, you may develop circulation problems in your arms and legs called peripheral artery disease. This can make you less sensitive to heat and cold, increasing your risk of burns or frostbite. In rare cases, poor circulation in your arms or legs can cause tissue death (gangrene).
Atherosclerosis can also cause aneurysms, a serious complication that can occur anywhere in your body. An aneurysm is a bulge in the wall of your artery. Most people with aneurysms have no symptoms. Pain and throbbing in the area of an aneurysm may occur and is a medical emergency.
If an aneurysm bursts, you may face life-threatening internal bleeding. Although this is usually a sudden, catastrophic event, a slow leak is possible. If a blood clot within an aneurysm dislodges, it may block an artery at some distant point.
If you think you may have atherosclerosis or are worried about having atherosclerosis because of a strong family history of heart disease, make an appointment with your doctor to have your cholesterol level checked.
During a physical exam, your doctor may find signs of narrowed, enlarged or hardened arteries, including:
Depending on the results of the physical exam, your doctor may suggest one or more diagnostic tests, including:
Lab tests can detect increased levels of cholesterol and blood sugar that may increase the risk of atherosclerosis. You'll need to go without eating or drinking anything but water for nine to 12 hours before your blood test. Your doctor should tell you ahead of time if this test will be performed during your visit.
Your doctor may use a special ultrasound device (Doppler ultrasound) to measure your blood pressure at various points along your arm or leg. These measurements can help your doctor gauge the degree of any blockages, as well as the speed of blood flow in your arteries.
This test can tell if you have atherosclerosis in the arteries in your legs and feet. Your doctor may compare the blood pressure in your ankle with the blood pressure in your arm. This is known as the ankle-brachial index. An abnormal difference may indicate peripheral vascular disease, which is usually caused by atherosclerosis.
An electrocardiogram records electrical signals as they travel through your heart. An ECG can often reveal evidence of a previous heart attack. If your signs and symptoms occur most often during exercise, your doctor may ask you to walk on a treadmill or ride a stationary bike during an ECG.
A stress test, also called an exercise stress test, is used to gather information about how well your heart works during physical activity. Because exercise makes your heart pump harder and faster than it does during most daily activities, an exercise stress test can reveal problems within your heart that might not be noticeable otherwise. An exercise stress test usually involves walking on a treadmill or riding a stationary bike while your heart rhythm and blood pressure and breathing are monitored. In some types of stress tests, pictures will be taken of your heart, such as during a stress echocardiogram (ultrasound) or nuclear stress test. If you're unable to exercise, you may receive a medication that mimics the effect of exercise on your heart.
This test can show if your coronary arteries are narrowed or blocked. A liquid dye is injected into the arteries of your heart through a long, thin tube (catheter) that's fed through an artery, usually in your leg, to the arteries in your heart. As the dye fills your arteries, the arteries become visible on X-ray, revealing areas of blockage.
Your doctor may use ultrasound, a computerized tomography (CT) scan or magnetic resonance angiography (MRA) to study your arteries. These tests can often show hardening and narrowing of large arteries, as well as aneurysms and calcium deposits in the artery walls.
Lifestyle changes, such as eating a healthy diet and exercising, are often the best treatment for atherosclerosis. Sometimes, medication or surgical procedures may be recommended as well.
Various drugs can slow — or even reverse — the effects of atherosclerosis. Here are some common choices:
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. Boosting your high-density lipoprotein (HDL) cholesterol, the "good" cholesterol, may help, too. Your doctor can choose from a range of cholesterol medications that help stabilize the lining of your heart arteries and prevent atherosclerosis.
Your doctor may prescribe anti-platelet medications to reduce the likelihood that platelets will clump in narrowed arteries, form a blood clot and cause further blockage.
These medications are commonly used for coronary artery disease. They lower your heart rate and blood pressure, reducing the demand on your heart and often relieve symptoms of chest pain. Beta blockers reduce the risk of heart attacks and some heart rhythm problems.
These medications may help slow the progression of atherosclerosis by lowering blood pressure and producing other beneficial effects on the heart arteries. ACE inhibitors can also reduce the risk of recurrent heart attacks.
These medications lower blood pressure and are sometimes used to treat angina.
High blood pressure is a major risk factor for atherosclerosis. Diuretics lower blood pressure.
Your doctor may suggest certain medications to control specific risk factors for atherosclerosis, such as diabetes. Sometimes specific medications to treat symptoms of atherosclerosis, such as leg pain during exercise, are prescribed.
Sometimes more aggressive treatment is needed. If you have severe symptoms or a blockage that threatens muscle or skin tissue survival, you may be a candidate for one of the following surgical procedures:
In this procedure, your doctor inserts a long, thin tube (catheter) into the blocked or narrowed part of your artery. A second catheter with a deflated balloon on its tip is then passed through the catheter to the narrowed area. The balloon is then inflated, compressing the deposits against your artery walls. A mesh tube (stent) is usually left in the artery to help keep the artery open.
In some cases, fatty deposits must be surgically removed from the walls of a narrowed artery. When the procedure is done on arteries in the neck (the carotid arteries), it's called a carotid endarterectomy.
If you have an artery that's blocked by a blood clot, your doctor may use a clot-dissolving drug to break it apart.
Your doctor may create a graft bypass using a vessel from another part of your body or a tube made of synthetic fabric. This allows blood to flow around the blocked or narrowed artery.
Smoking damages your arteries and speeds up atherosclerosis.
A heart-healthy diet based on fruits, vegetables and whole grains — and low in saturated fat, cholesterol and sodium — can help you control your weight, blood pressure and cholesterol.
Regular exercise can improve circulation and lower blood pressure. Aim for at least 30 minutes of moderate physical activity most days of the week.
Being overweight increases your risk of high blood pressure, diabetes and high cholesterol — all risk factors for atherosclerosis.
Just remember to make changes one step at a time, and keep in mind what lifestyle changes are manageable for you in the long run.
It's thought that some foods and herbal supplements can help reduce your high cholesterol level and high blood pressure, two major risk factors for developing atherosclerosis. With your doctor's OK, consider these supplements and products:
Talk to your doctor before adding any of these supplements to your atherosclerosis treatment. Some supplements can interact with medications, causing harmful side effects.
You can also practice relaxation techniques, such as yoga or deep breathing, to help you relax and reduce your stress level. These practices can temporarily reduce your blood pressure, reducing your risk of developing atherosclerosis.
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