Related topics: •  Heart & Cardiovascular Disease •  Heart Attack (Myocardial Infarction)

In simplest terms, atherosclerosis is the buildup of cholesterol and other fats on the walls of arteries. Why should you care? Pick up the obituary section of your paper. If it weren't for atherosclerosis, a lot of those people wouldn't be there.

Atherosclerosis -- often called hardening of the arteries -- is the underlying cause of almost all heart attacks and strokes. If you have the condition, now's the time to act. With some healthy lifestyle changes and a little help from your doctor, you can defuse atherosclerosis before it threatens your life. If you don't have atherosclerosis, you should know what it takes to avoid America's number-one killer.

Your bloodstream is a highway for many substances, including cholesterol and other fats. Most of the time, these fats pass by harmlessly. But if something damages or inflames the walls of the arteries, the vessels become "sticky." These sticky patches can collect fats as they float by.

The process starts at an early age. Most people have small streaks of fat in their aorta -- the main artery feeding the heart-by the time they turn ten. By themselves, fatty streaks are harmless. But if conditions are right, fat will continue to collect in the arteries, turning the streaks into fatty clumps or "plaques" -- the hallmark of atherosclerosis.

Anything that inflames the arteries can set atherosclerosis in motion. Smoking and high blood pressure are two of the most common culprits. Recent studies have found that high levels of cholesterol also irritate the arteries. In other words, cholesterol provides both the foundation and the raw materials for atherosclerosis.

Atherosclerosis can form in large and medium arteries anywhere in the body, especially in the legs, feet, brain and near the heart. When atherosclerosis affects the arteries that feed the heart, the condition is called coronary heart disease.

In some cases, fatty plaques can grow so large that they completely block the blood flow in an artery. When this happens in arteries feeding the heart, it causes a heart attack. Blockages in the brain cause strokes.

Most heart attacks and strokes get their start when a plaque ruptures. When a plaque ruptures, it often releases certain proteins that make the blood clot. If the clot is big enough, it may eventually plug up an artery, triggering a heart attack or stroke.

In its earliest stages, atherosclerosis is a silent disease. Some people never have symptoms, even as they approach the brink of a heart attack or stroke. Most people, however, will notice some warning signs. The symptoms may be subtle or severe, but they should never be taken lightly.

Clogged arteries in your lower extremities can cause pain, especially in your calves and your feet. The pain usually strikes during exercise and disappears when you rest. If an artery becomes completely blocked, your foot may become pale, cold, and painful.

Atherosclerosis in the arteries surrounding the heart -- coronary artery disease -- can make you short of breath. You may also feel chest pain, often called angina. Angina isn't just an ache; you'll probably have a heavy, tight, burning, squeezing sensation right behind your breastbone. The symptoms may also spread to your jaw, throat, or one arm. The attacks usually come on during exertion or emotional stress, and they go away when you rest or calm down. If the attacks suddenly become more common or if they start arriving while you're resting, a heart attack may be right around the corner.

Remember: Atherosclerosis is basically a two-step process. Something injures the arteries, then plaques begin to stick to the site of the injury. If you can protect your arteries from damage and keep your cholesterol levels from getting too high, you can greatly lower your risk of atherosclerosis.

If you already have atherosclerosis, a heart-healthy lifestyle is critical. Although some people may also need medications to control their cholesterol, many people can slow down the buildup of plaque and reduce their cholesterol by adopting a healthy diet and exercise. Lowering your cholesterol levels can help to stabilize plaque, making it less likely to rupture. Cholesterol-lowering statin drugs have anti-inflammatory properties that appear to stabilize plaque as well. If you are considered high risk and your low-density lipoprotein level is over 130, your doctor will likely recommend that you begin taking medication immediately, while also improving your diet and exercise regimen.

Here's a look at the top strategies for avoiding or defusing atherosclerosis:

•If you smoke, stop. Giving up cigarettes RIGHT NOW is the best thing you can do for your arteries and your heart. If you have trouble quitting on your own, join a support group or ask your doctor for help. Effective medications are available for this challenge.

•Eat a heart-healthy diet. The American Heart Association recommends getting 25 to 35 percent of your calories from fat. Recent federal guidelines on cholesterol now say it's okay to get up to 35 percent of your calories from fat, as long as most of it is unsaturated. You should also eat less than 300 milligrams of cholesterol each day. If you already have atherosclerosis, you should get less than 7 percent of your calories from saturated fat. This is important because the body uses saturated fat to manufacture cholesterol. In addition, cut your cholesterol intake to less than 200 milligrams each day. (By way of comparison, a large egg may contain up to 250 milligrams of cholesterol.)

To reach these goals, you should avoid fatty meats, fried foods, and dairy products made from 2 percent or whole milk. Instead, eat lean cuts of meat, skinless poultry, and skim or 1 percent milk, cheeses, and other dairy products. (It's important to have some good fats, such as those found in olive oil and the omega-3 fatty acids found in flaxseed oil and cold-water fish such as salmon, in your diet. Fish oil supplements containing omega-3s are also widely available.) Round out your diet with plenty of whole-grain foods and at least five servings of fruits and vegetables every day. For more information on a heart healthy diet, see Warding Off Heart Disease Through Diet.

•Get moving. Regular exercise can strengthen your heart, improve your cholesterol levels, lower your blood pressure, burn off extra pounds, and just plain make you feel good. And it doesn't take an Olympic effort. The American Heart Association recommends at least 30 minutes of moderately vigorous exercise (enough to break a sweat) at least four times each week and preferably every day. But any exercise is good. The Wellness Letter from University of California at Berkeley reported that a group of women over 45 who walked an hour a week had half the risk of coronary artery disease as those who didn't exercise. Of course, exercise can be risky for some people. Check with your doctor before starting a new workout program.

•Team up with your doctor. The American Heart Association recommends that doctors evaluate patients for their general risk of cardiovascular disease starting at age 20. As part of the assessment, your doctor should check your blood pressure, body mass index, waist measurement, and pulse, and repeat the assessment at least every two years. Your cholesterol and glucose levels should be monitored every five years (every two years if you have risk factors for heart disease). If you're 40 or over or have multiple risk factors, the AHA recommends that your doctor calculate what the chances are that you'll develop cardiovascular disease in the next 10 years.

If you have high blood pressure or high cholesterol that can't be controlled with diet and exercise, you may need prescription medications to bring your numbers down.

You should also be sure to avoid cigarettes, get regular exercise, and do anything else you can to protect your heart.

If one or more of the arteries feeding your heart become severely clogged, you may need treatment to restore the flow of blood to your heart. One option is coronary artery bypass surgery. Using a vessel from another part of your body, a surgeon can create a detour around the blocked artery. Another option is angioplasty, a procedure that involves threading a catheter through the clogged artery. Once the catheter is in place, it can widen the artery by inflating a small balloon, firing a laser, rotating a tiny blade, or leaving a small metal scaffold called a stent.

If your arteries aren't severely blocked but you're still bothered by angina, your doctor may prescribe beta-blockers, nitroglycerin or other medications to ease your symptoms.

Recent discoveries about atherosclerosis have raised exciting possibilities for effective new treatments. Soon, doctors may be able to prescribe drugs that prevent plaques from rupturing. They may even be able to use gene therapy to rapidly remove plaques. Until then, you'll just have to stick to the basics: a healthy lifestyle, low blood pressure, and low cholesterol levels. Atherosclerosis may be the leading cause of death in America, but you probably have the power to take at least one name off the casualty list.

-- Chris Woolston, M.S., is a health and medical writer with a master's degree in biology. He is a contributing editor at Consumer Health Interactive, and was the staff writer at Hippocrates, a magazine for physicians. He has also covered science issues for Time Inc. Health, WebMD, and the Chronicle of Higher Education. His reporting on occupational health earned him an award from the northern California Society of Professional Journalists.

References

Last updated July 27, 2009
Copyright © 2001 Consumer Health Interactive

or find more on:

Back to top of page