Hardening of the Arteries

Hardening of the arteries, also called atherosclerosis, is a common disorder. It occurs when fat, cholesterol, and other substances build up in the walls of arteries and form hard structures called plaques. Over time, these plaques can block the arteries and cause problems throughout the body.

arteries

Hardening of the Arteries Overview

Hardening of the arteries (atherosclerosis) is a disorder in which arteries (blood vessels that carry oxygenated blood from the heart to other parts of the body) become narrowed because fat (cholesterol deposits called atherosclerosis) is first deposited on the inside walls of the arteries, then becomes hardened by fibrous tissue and calcification (arteriosclerosis). As this plaque grows, it narrows the lumen of the artery (the space in the artery tubes), thereby reducing both the oxygen and blood supply to the affected organ (like the heart, eyes, kidney, legs, gut, or the brain). The plaque may eventually severely block the artery, causing death of the tissue supplied by the artery, for example, heart attack or stroke.

When the arteries of the heart (coronary arteries) are affected by arteriosclerosis, the person can develop angina, heart attack, congestive heart failure, or abnormal cardiac rhythms (because of coronary artery disease). When the arteries of the brain (cerebral arteries) are affected by arteriosclerosis, the person can develop a threatened stroke,called transient ischemic attack, or actual death of brain tissue, called stroke. Hardening of the arteries is a progressive condition that may begin in childhood. Fatty streaks can develop in the aorta (the largest blood vessel supplying blood to both the upper and lower part of the body) shortly after birth. In those people with familial history of high cholesterol, the condition may worsen rapidly in the early 20s and progressively become more severe in the 40s and 50s.

In the United States, approximately 1.5 million heart attacks occur annually, and more than 11 million Americans have been diagnosed as having coronary artery disease. According to the American Heart Association 2004 Heart and Stroke Statistical Update, arteriosclerosis accounts for nearly 75% of all deaths from heart disease.

In persons older than 50 years, 30% also have some evidence of carotid artery (artery in the neck supplying blood to the brain) disease. Cerebrovascular disease is responsible for over 200,000 deaths per year in the United States.

The incidence of coronary heart disease in the Far East is significantly lower than in the West. Possible genetic reasons for this difference are not clearly defined. However, the role of the Western diet, lack of exercise, obesity, and other environmental factors may be responsible contributory factors for the differences.

Hardening of the Arteries Causes

The exact cause of arteriosclerosis is not known; however, risk factors for the development and progression of arteriosclerosis have been identified. The risk factors can be divided into factors that can be changed and those that cannot.

Risk factors that can be changed include the following:

  • High blood pressure
  • High blood cholesterol levels, especially low-density lipoprotein cholesterol or LDL cholesterol (bad cholesterol)
  • Cigarette smoking
  • Diabetes
  • Obesity
  • Lack of exercise
  • Western diet, with excessive saturated fat in meat, dairy products, eggs, and fast foods (the McDonald’s Syndrome) with inadequate fruits, vegetables, and fish

Risk factors that cannot be changed include the following:

  • Advancing age
  • Being male (Women are at lower risk only until menopause.)
  • Having a close relative who has had heart disease or stroke at a relatively young age (bad genes, especially with familial hypercholesterolemia [increased cholesterol levels]).
  • Race: African Americans have excessive and early degree of high blood pressure, leading to premature stroke, heart attack, congestive heart failure, and death.

Hardening of the Arteries Symptoms

Arteriosclerosis often does not cause symptoms until the lumen of the affected artery is critically narrowed or is totally blocked.

The symptoms of arteriosclerosis are highly variable and can range from no symptoms (in the early stage of the disease) to heart attack or stroke (when the lumen of the artery is critically blocked). Sudden cardiac death can also be the first symptom of coronary heart disease. Symptoms also depend on the location of the arteries affected by arteriosclerosis.

  • arteries2If the coronary arteries supplying the heart are affected, the person may develop chest pain, shortness of breath, sweating, and anxiety. The specific chest pain (angina), or inadequate blood flow to the heart muscle, generally occurs with exertion and disappears at rest. Classically, angina is a tight, heavy, oppressive sensation in the middle of the chest. Rarely, angina can occur at rest and signifies a more unstable plaque and possibly a threatened heart attack.
  • Many types of chest pain are not angina, including sore muscles and ligaments in the chest wall; injured lungs surrounding the heart; and a raw, sore esophagus, which runs down through the chest behind the heart. If the carotid or vertebral arteries supplying the brain are affected by arteriosclerosis, the person may develop numbness, weakness, loss of speech, difficulty swallowing, blindness, or paralysis of a part of the body (usually one-half of the body).
  • If the arteries supplying the legs are affected (see Peripheral Vascular Disease), the person may have severe pain in the legs. The pain typically comes when a person is walking and goes away when he or she stops walking (intermittent claudication). When the disease is severe, the pain may come on at rest and/or at night. If the skin breaks down, the wound may become infected and never heal, potentially leading to amputation.
  • If the arteries supplying the kidneys are affected, the person can have symptoms of high blood pressure or may develop kidney failure.

For more information please see Clogged Arteries

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