ATHEROSCLEROSIS

General Information

DEFINITION--An extremely common form of hardening of the arteries in which plaque deposits form in the walls of the blood vessels that carry oxygen and other nutrients from the heart to other body parts. Atherosclerosis may lead to kidney damage, decreased circulation to the brain and extremities, and coronary-artery disease. Atherosclerosis is a major cause of strokes and heart attacks.

BODY PARTS INVOLVED--All arterial blood vessels in the body.

SEX OR AGE MOST AFFECTED--Both sexes of adolescents and adults. Up to age 45, atherosclerosis is more common in men. After menopause, women have the same incidence.

SIGNS & SYMPTOMS--

Symptoms are often absent until atherosclerosis reaches advanced stages. Symptoms depend on what part of the body has a decreased blood flow and the extent of disease. Common symptoms include:

• Muscle cramps if atherosclerosis involves vessels in the legs.
• Angina pectoris or heart attack if it involves blood vessels to the heart.
• Stroke or transient ischemic attack if it involves vessels to the neck and brain.

CAUSES--Patches of fatty tissue that damage artery walls often collect at artery junctions. At these points, the inner lining of the artery may trap fatty substances that circulate in the blood. As fatty deposits accumulate, they reduce the blood vessel's elasticity and narrow the passageway, interfering with blood flow. This process may begin in early adulthood.

RISK INCREASES WITH

• Adults over 60; stress; diabetes mellitus; high blood pressure; obesity; smoking; sedentary lifestyle.
• Poor nutrition, especially too much fat and cholesterol in the diet.
• Family history of atherosclerosis.
• High cholesterol levels (high levels of the low density lipoprotein and low levels of the high density lipoprotein).

HOW TO PREVENT

• Don't smoke.
• Follow suggestions under Diet. Children and young adults of parents with this condition may benefit from a low-fat diet. Exercise regularly.
• Reduce stress when possible (see How to Cope with Stress in Appendix).
• If you have diabetes or high blood pressure, adhere strictly to your treatment program.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and exam by a doctor.
• Laboratory studies, including: ECG (See Glossary); exercise-tolerance test; blood studies of cholesterol and high-density lipoproteins (See Glossary); and blood-sugar tests; x-rays of the chest and blood vessels.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.
• Psychotherapy or counseling to learn to cope with stress.
• Surgery available in some cases.

POSSIBLE COMPLICATIONS

Heart attack; stroke and/or angina pectoris; kidney disease; congestive heart failure; heartbeat irregularities; sudden death.

PROBABLE OUTCOME--This condition is currently considered incurable. However, symptoms can be controlled, and progress of the disease can be slowed with treatment. Complications are eventually fatal.

How To Treat

GENERAL MEASURES--

• Treatment for atherosclerosis is generally directed at its complications.
• Stop smoking.
• See Resources for Additional Information.

MEDICATION--

• Lowering cholesterol levels in persons with high levels can increase life expectancy. If diet and exercise fail to reduce cholesterol, your doctor may prescribe antihyperlipidemic drugs.
• Other drugs may be necessary to treat symptoms of an associated problem (high blood pressure, heartbeat irregularities).
• Some studies have indicated that aspirin and vitamin E may reduce the risk of heart attack. Get medical advice to see if they should be recommended for you.

ACTIVITY--Usually no restrictions. Routine exercise is recommended.

DIET-- Eat a diet that is low in fat, low in salt and high in fiber (see Appendix for special diets).

Call Your Doctor If

You have high risk factors for atherosclerosis and want to be in a prevention program.