Understanding Atherosclerosis: The Leading Cause of Heart Disease

Atherosclerosis (pronounced: a·thuh·row·skluh·row·suhs) is a condition that is not only hard to pronounce but underlies the development of most cardiovascular diseases. 

Sometimes called arteriosclerosis or “hardening of the arteries,”  it occurs when fatty deposits called plaque build up inside the arteries over time. 

This causes the arteries to narrow and stiffen, restricting blood flow to the heart, brain, and other vital organs. 

Atherosclerosis is the #1 cause of heart attacks, strokes, and other serious complications. 

By understanding what causes this disease and how to prevent it, we can greatly improve our odds of aging with a healthy heart.

Atherosclerosis: The Plaque Buildup Process

Atherosclerosis stems from chronic inflammation within the arterial walls. Here is how it develops:

• Tiny tears in the arterial lining allow LDL (bad) cholesterol to seep in and become oxidized or damaged.
• White blood cells detect this cholesterol as a foreign substance and release inflammatory chemicals in response.
• This causes smooth muscle cells and scar tissue to accumulate around the cholesterol, forming a plaque lesion or buildup.
• Plaque is comprised of fat, cholesterol, calcium, and cellular debris.
• Over time, rupture-prone plaques can form a thin fibrous cap covering a soft lipid core.
• Plaques expand into the arterial lumen, narrowing and hardening the vessels.

Major Risk Factors

Certain lifestyle factors significantly increase one’s risk of developing atherosclerosis:

• High blood pressure: Arterial damage from excessive pressure enables plaque formation.
• Elevated LDL cholesterol: high levels allow more plaque buildup in the arteries.
• Cigarette smoking: the chemicals in smoke damage artery walls.
• Diabetes: Excess glucose can accelerate atherosclerosis.
• Obesity: excess fatty tissue contributes to clogged arteries.
• Physical inactivity: Lack of exercise leads to plaque accumulation.
• Unhealthy diet: saturated fats, trans fats, salt, sugar, and processed foods promote plaque.
• Excess alcohol can elevate blood pressure and triglycerides.
• Chronic stress releases cortisol and inflammatory compounds.

In addition, factors like genetics, age, and gender affect personal risk levels. Men over 45 and women over 55 face greater odds due to hormonal changes.

Signs and symptoms

In its early stages, atherosclerosis does not cause noticeable symptoms. Plaque slowly builds up over decades without impairing blood flow. Symptoms arise when arteries become severely narrowed or fully blocked by plaque. Warning signs include:

• Angina: chest pain with exertion as the heart struggles to get oxygenated blood.
• Heart attack: total blockage of arteries supplying the heart muscle leads to damage or death of heart tissue.
• Stroke: Blocked arteries in the brain cut off oxygen, killing brain cells.
• Peripheral artery disease: plaque in the limbs causes leg pain with activity.
• Kidney failure: reduced blood flow damages the kidneys.
• Erectile dysfunction: insufficient pelvic artery blood supply.

Catching atherosclerosis early is key before critical circulatory damage occurs. Screening tests identify plaque before symptoms arise.

Diagnosis and Screening

Several methods can detect atherosclerosis:

• Ultrasound produces images of plaque buildup in artery walls. Carotid ultrasounds check the neck arteries.
• CT scan: highly detailed X-rays assess plaque in the coronary arteries.
• Ankle-brachial index: compares blood pressure in the ankles to that in the arms to identify peripheral artery blockages.
• Coronary calcium score: measures calcified plaque in the heart arteries.

Doctors may recommend screening tests if you have multiple risk factors, are over the age of 45, or have a family history of atherosclerosis. Make sure to discuss your risks and screening options with your physician.

Treatment Approaches

While atherosclerosis cannot be reversed, progression can be stopped and complications prevented with medical treatment.

• Cholesterol medication: Statins lower LDL levels in the blood to reduce plaque growth.
• Anti-hypertensives: Keep blood pressure controlled below 120/80.
• Anti-platelets: Help prevent clotting and blockages.
• Nitrates are vasodilators that open up narrowed arteries.

Procedures like angioplasty can widen blocked arteries by pushing plaque back against the artery wall. Bypass surgery uses grafts to route blood around severely clogged areas.

Adopting lifestyle changes is critical; the best “treatment” is prevention. Quitting smoking, losing weight, reducing alcohol intake, and managing stress all help halt atherosclerosis. But the most vital steps are improving your diet and increasing physical activity.

The dietary approach to stopping atherosclerosis focuses on heart-healthy foods like vegetables, fruits, whole grains, legumes, fish, and olive oil. Limit cholesterol, saturated fats, salt, sugars, and processed items. 

Aim for 150 minutes per week of moderate exercise plus strength training. Maintaining healthy cholesterol, blood pressure, and glucose levels through lifestyle changes reduces your risks substantially.

Atherosclerosis may be common, but it doesn’t have to be inevitable. Understand the risk factors and causes, get screened early, and work with your doctor on treatment options. But make healthy choices each day to keep your arteries supple and maintain a happy heart.

Final thoughts

Seeing our aging parents and grandparents suffer from atherosclerosis and its effects, like heart attacks and strokes, is agonizing. 

The sense of helplessness as this disease progresses can be overwhelming. 

But we should not lose hope or feel powerless. Supporting loved ones with atherosclerosis starts with educating ourselves on their condition. Learning about causes, symptoms, and screening empowers us to have meaningful discussions with them about prevention and lifestyle changes. 

Providing tools like blood pressure monitors and pill organizers shows we’re invested in their health. Preparing plant-based meals and going on walks together make healthy living a shared activity. 

And most importantly, giving them our time, patience, and affection reminds them they’re never alone. 

Though atherosclerosis presents challenges, our support reminds them that life is still rich and worth living fully. Don’t wait to make heart-healthy choices together and show your elderly loved ones how much you care; these actions can inspire their fight against this disease.

For more information, you can read more from John Hopkins.