Atherosclerosis is the hardening and narrowing of the arteries in the body. Arteries are the blood vessels that carry blood from the heart to the body. When we are younger, our arteries are very flexible and can respond appropriately to changes in blood pressure. However, as we age, higher blood pressure over time as well as buildup of cholesterol plaques can lead to hardening of the arteries. These smaller and less flexible arteries can’t always get enough oxygen-rich blood to the organs that require oxygen like the heart or muscles. Atherosclerosis can affect arteries around the heart but also anywhere in the body causing coronary artery disease (which leads to heart attacks), carotid artery disease (which causes strokes), peripheral artery disease (which causes leg pain with walking), and aneurysms (bulging of the arteries leading to an increased risk of rupture and bleeding). The plaques that build in the arteries can break, allowing a clot to form which can cause problems like heart attacks. Factors that contribute to the formation of atherosclerosis include elevated cholesterol, elevated blood pressure, smoking, obesity and diseases like diabetes. Early atherosclerosis has no symptoms. Symptoms that develop later depend on which part of the body is affected by the narrowed and stiff arteries. The good news is that great treatment options exist to improve your health and decrease atherosclerosis.
No symptoms, chest pain, leg pain when walking, slurred speech or difficulty speaking, drooping of one side of the face, erectile dysfunction
Your doctor will first take a history and perform a physical exam. O the physical exam, your doctor or cardiologist will specifically check for the following signs: decreased pulses, lower blood pressure in the extremities, bruits over the arteries (a sound made by turbulent blood flow heard with the stethoscope), or wounds that don’t seem to heal. Your doctor will likely want to do some blood tests including cholesterol levels and blood sugar (to check for diabetes). Your doctor may recommend additional tests like an ultrasound of the arteries (to look at the blood flow in the arteries and see how restricted the vessels may be), an ankle-brachial index (a comparison of the blood pressure in the arms and legs), electrocardiogram or EKG (which takes a picture of the electrical activity of the heart to look for any areas of restricted blood flow in the heart), or a CT scan of the heart (which can take a picture of the arteries). A person with atherosclerosis may also need an angiogram, a procedure done by a doctor with specialized training called an interventional cardiologist. During this procedure, a thin wire is placed in one of the blood vessels in the leg or wrist and fed up to the heart. The cardiologist then injects dye through that small wire and takes pictures of the arteries of the heart. If vessels are found which are too small, the cardiologist may be able to either use small balloons to open them or place stents (tube-shaped wire meshes) which helps keep the arteries open.
Treating atherosclerosis begins with eating a healthy diet and exercising which help lower blood pressure, lose weight, decrease chances of diabetes, and decrease cholesterol. In addition to making lifestyle changes, medications are available to decrease atherosclerosis. Medication options include those to decrease cholesterol, those to keep platelets from forming clots, blood thinner, and medications to treat high blood pressure or diabetes. Your doctor or cardiologist may recommend additional procedures like placing stents during angiogram, removing thinned sections of the arteries and reconnecting the healthier ends (especially in the carotid artery of the neck to prevent strokes called carotid endarterectomy), or even coronary artery bypass surgery (where veins from elsewhere in the body are attached to the arteries in the heart before and after a blockage, allowing blood to bypass the blocked area and reach the heart muscle). You should discuss all of your treatment options with your doctor or cardiologist.
