Atherosclerosis

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. Healthy arteries are flexible and elastic, but over time, the walls in your arteries can harden, a condition commonly called hardening of the arteries.

Symptoms

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, 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 symptoms of peripheral artery disease, such as leg pain when walking (intermittent claudication).
• If you have atherosclerosis in the arteries leading to your kidneys, you develop high blood pressure or kidney failure.
• If you have atherosclerosis in the arteries leading to your genitals, you may have difficulties having sex. Sometimes, atherosclerosis can cause erectile dysfunction in men. In women, high blood pressure can reduce blood flow to the vagina, making sex less pleasurable.

When to see a doctor

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

Causes

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:

• High blood pressure
• High cholesterol, often from getting too much cholesterol or saturated fats in your diet
• High triglycerides, a type of fat (lipid) in your blood
• Smoking and other sources of tobacco
• Diabetes
• Inflammation from diseases, such as arthritis, lupus or infections, or inflammation of unknown cause

Risk factors

Hardening of the arteries occurs over time. Besides aging, factors that increase the risk of atherosclerosis include:

• High blood pressure
• High cholesterol
• Diabetes
• Obesity
• Smoking and other tobacco use
• A family history of early heart disease
• Lack of exercise

Complications

The complications of atherosclerosis depend on which arteries are blocked. For example:

• Coronary artery disease
• Carotid artery disease
• Peripheral artery disease
• Chronic kidney disease
• Aneurysms

Tests and diagnosis

During a physical exam, your doctor may find signs of narrowed, enlarged or hardened arteries, including:

• A weak or absent pulse below the narrowed area of your artery
• Decreased blood pressure in an affected limb
• Whooshing sounds (bruits) over your arteries, heard using a stethoscope
• Signs of a pulsating bulge (aneurysm) in your abdomen or behind your knee
• Evidence of poor wound healing in the area where your blood flow is restricted

Depending on the results of the physical exam, your doctor may suggest one or more diagnostic tests, including:

• Blood tests
• Electrocardiogram (ECG)
• Stress Test / Exercise Tolerance Test (ETT)
• Cardiac catheterization and angiogram
• Doppler ultrasound to measure your blood pressure
• Ankle-brachial index
• Other imaging tests

Treatments and drugs

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:

• Cholesterol medications
• Anti-platelet medications
• Beta blocker medications
• Angiotensin-converting enzyme (ACE) inhibitors
• Calcium channel blockers
• Diuretics
• Other medications

Sometimes more aggressive treatment is needed.Like:

• Angioplasty and stent placement
• Bypass surgery
• Thrombolytic therapy
• Endarterectomy

Prevention

The same healthy lifestyle changes recommended to treat atherosclerosis also help prevent it. These include:

• Stop smoking
• Eating healthy foods
• Exercise regularly
• Maintaining a healthy weight

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.