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Atherosclerosis, hardening of the arteries

Alternative Names 
arteriosclerosis, hardening of the arteries

Arteriosclerosis, or hardening of the arteries, refers to fatty deposits formed under the inner lining of the blood vessels. The walls of the vessels become thick and less elastic. The thickened areas are called plaque.

What is going on in the body? 
Arteriosclerosis is caused by an injury to the inside layer of the artery. It usually occurs where the artery bends or branches. Damage to the walls of the artery may be caused by a number of factors, including: After the artery wall is injured, white blood cells move into the area and begin to collect fat. This fat is left mostly by LDL, or so-called bad cholesterol. Smooth muscle cells also form part of the plaque. The artery wall can become inflamed.

Two problems can result from the plaque.
  • First, the blood vessel can become narrow, preventing blood flow to the area served by the artery. For example, if an artery to the heart becomes 80% to 90% closed off, a person can develop chest pain, especially during or after exercise.
  • Second, the plaque can rupture and send a blood clot streaming through the artery. A blood clot that travels to other parts of the body is called an embolism. The embolism can be deposited in a smaller area of the artery or in another artery, completely blocking off the blood supply. This blockage can cause a heart attack, stroke, pulmonary embolism, or other serious medical problem.
What are the signs and symptoms of the disease? 
The symptoms of arteriosclerosis depend on which arteries are most affected by the build up of plaque. Arteriosclerosis can affect the heart, the kidneys, and virtually any other organ.
  • Arteriosclerosis of the arteries in the heart is called coronary artery disease. It can produce chest pain and heart attack.
  • Arteriosclerosis of the blood vessels leading to the brain can cause a stroke.
  • Arteriosclerosis of the blood vessels in the legs can result in leg pain during or after exercise, which is called intermittent claudication.
What are the causes and risks of the disease? 
Several factors increase a person's risk of developing arteriosclerosis, including: What can be done to prevent the disease? 
A person may be able to reduce his or her risk for developing arteriosclerosis by controlling diabetes, high blood pressure, and high cholesterol. Maintaining a healthy body weight, getting 30 minutes of physical activity daily, and eating a heart-healthy diet.

How is the disease diagnosed? 
Arteriosclerosis is usually diagnosed by symptoms in the area where blood supply is reduced. Such symptoms as chest pain, stroke, or leg pain with exercise frequently lead to a diagnosis of arteriosclerosis. A variety of special tests can check the width of the openings in the arteries supplying the affected areas.

What are the long-term effects of the disease? 
Unchecked arteriosclerosis will continue to narrow the large and medium arteries supplying the body's vital organs. This can result in serious medical problems, including heart attack, kidney failure, and stroke.

What are the risks to others? 
Arteriosclerosis is not contagious, but it does seem to run in families. If one or both parents have arteriosclerosis, an individual should make every effort to reduce his or her coronary risk factors. This is especially true for people whose parents have arteriosclerosis early in life.

What are the treatments for the disease? 
Treatment of arteriosclerosis focuses on lowering a person's coronary risk factors. Lowering blood cholesterol, controlling high blood pressure, and stopping smoking can stabilise plaques. However, these measures may not reverse the process.

A low dose of aspirin taken on a regular basis seems to reduce the development of clot on an arteriosclerotic plaque.

Arteriosclerosis that progresses far enough to cause symptoms may require surgery. Surgery can remove or bypass plaques in the arteries that supply the brain, heart, kidneys, or legs. Angioplasty is a procedure in which a small balloon is inserted into an area of plaque and then inflated. When the balloon is deflated and removed, the opening within the artery is larger and the blood supply is improved.

What are the side effects of the treatments? 
Side effects depend on the treatment chosen for the arteriosclerosis. Medications can have varied side effects, including allergic reactions. Surgery carries a risk of bleeding, infection, and allergic reaction to anaesthesia.

What happens after treatment for the disease? 
Most individuals with arteriosclerosis are encouraged to begin a regular exercise program. A person with arteriosclerosis should make every effort to reduce coronary risk factors. This may include smoking cessation, control of chronic diseases and conditions such as diabetes and high blood pressure, and a healthy, low-fat diet for preventing heart disease. Medications may need to be adjusted to achieve the best response.

How is the disease monitored? 
A person will have regular visits to the doctor, along with tests to monitor the progress of the arteriosclerosis. Any new or worsening symptoms should be reported to the doctor.

Author: William M. Boggs, MD
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 6/11/2005
Potential conflict of interest information for reviewers available on request

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