Article title: ATHEROSCLEROSIS: NWHIC
What is plaque?
What causes plaque to form in arteries?
What are the symptoms of atherosclerosis?
What risk factors raise my chances of having atherosclerosis?
What is homocysteine?
How is atherosclerosis diagnosed?
How is atherosclerosis treated?
Can I prevent or reverse atherosclerosis?
Atherosclerosis is the buildup of fatty deposits called plaque on the inside walls of arteries. Arteries are blood vessels that carry oxygen and blood to the heart, brain, and other parts of the body. As plaque builds up in an artery, the artery gradually narrows and can become clogged. As an artery becomes more and more narrowed, less blood can flow through. The artery may also become less elastic ("hardening of the arteries"). Atherosclerosis is the main cause of a group of diseases called cardiovascular diseases—diseases of the heart and blood vessels.
Source of enlargement: National Heart, Lung, and Blood Institute
Atherosclerosis can lead to clogged arteries in any part of the body. When the arteries to the heart are affected, angina (chest pain) or a heart attack may result. If arteries in the leg are affected, leg pain may occur. Atherosclerosis of the arteries to the brain can cause strokes.
Atherosclerosis is common in the United States. It often starts in childhood and the arteries become narrowed or clogged over many years.
Plaque is a combination of cholesterol, other fatty materials, calcium, and blood components that stick to the artery wall lining. A hard shell or scar covers the plaque. Plaques have various sizes and shapes. Some plaques are unstable and can rupture or burst. When this happens, it causes blood clotting inside the artery. If a blood clot totally blocks the artery, it stops blood flow completely. This is what happens in most heart attacks and strokes.
Although many risk factors are well known, the exact causes of atherosclerosis are not clear. Too much cholesterol in the blood, damage to the artery wall, and inflammation appear to play important roles in plaque buildup. Researchers are studying why and how the arteries become damaged, how plaque develops and changes over time, and why plaque can break open and lead to blood clots. There may be other factors that prove to be important in causing atherosclerosis.
There are usually no symptoms until one or more arteries are so clogged with plaque that blood flow is severely reduced. This reduced flow of blood and oxygen to some part of the body (such as the heart) is called ischemia and may cause pain or discomfort. Some people have no symptoms until a blood clot forms, completely blocks an already narrowed artery, and causes a heart attack or stroke.
The symptoms you have depend on which arteries are badly clogged and what part of the body is affected by the reduced flow of blood.
If arteries taking blood to your heart muscle are affected, you have coronary artery disease (CAD). You may have chest pain called angina that happens when you exert yourself and goes away when you rest. You could also have a heart attack.
If arteries taking blood to your brain are affected, you have cerebrovascular disease. You could have a transient ischemic attack (TIA) or a stroke.
If arteries taking blood to your legs are affected, you have peripheral arterial disease (PAD). You may have pain in the calf or thigh muscle called intermittent claudication that happens when you walk. This kind of pain goes away when you stop and rest.
All of these conditions are serious and should not be ignored. Arteries taking blood to the intestines, the kidneys, or other organs can also become clogged by plaque. This can sometimes lead to a medical emergency similar to a heart attack or stroke. Atherosclerosis can also cause erectile dysfunction in men.
These risk factors raise your chances of having atherosclerosis:
having high blood cholesterol, especially high LDL ("bad cholesterol") and low HDL ("good cholesterol") levels
aging and being male (women are affected more after menopause)
having close relatives who had heart disease or a stroke at a relatively young age
having high blood pressure
having trouble managing stress
having high levels of homocysteine (an amino acid) in the blood
being physically inactive.
The more risk factors you have, the more likely it is that you have atherosclerosis. Talk with your health care provider about your risks for atherosclerosis and cardiovascular disease.
Homocysteine is an amino acid that is found naturally in the body. High levels of homocysteine in the blood are believed to damage arteries, make the blood more likely to clot, and/or make blood vessels less flexible. Research has shown that the level of homocysteine in the blood is linked to three B vitamins—folic acid and vitamins B6 and B12. People who don't get enough of these vitamins in their diet have higher levels of homocysteine in their blood. The best way to get vitamins is through eating a healthy, varied diet, but some people may benefit from taking supplements. However, more research is needed to find out if lowering homocysteine levels can actually reduce the risk of cardiovascular disease.
If you don't have any symptoms and have not been diagnosed with cardiovascular disease, it is not easy to tell if your arteries are becoming clogged with plaque. But if you have high blood cholesterol, are overweight and get little exercise, smoke, or have other risk factors, there is a good chance that you have atherosclerosis. Eventually it can lead to heart disease, a stroke or other problems.
There are a number of tests that doctors use in diagnosing cardiovascular diseases, including blood tests, electrocardiograms (ECG), stress testing, coronary angiography, ultrasound, and computed tomography (CT). If you are at high risk for cardiovascular disease, your health care provider may suggest that you be tested.
Researchers are studying new tools to help find cardiovascular disease in earlier stages, before symptoms appear. For example, the National Heart, Lung, and Blood Institute is sponsoring a ten-year study called the Multi-Ethnic Study of Atherosclerosis (MESA). The MESA study will help show which risk factors are the best predictors of future heart disease in men and women and in certain ethnic groups.
If your atherosclerosis leads to symptoms, the symptoms (such as angina) can be treated. Medicines are usually the first step in treating cardiovascular diseases. Other treatments include angioplasty procedures to open up clogged arteries and surgery, such as bypass surgery.
If you have high blood pressure, diabetes, or high blood cholesterol, these conditions can be treated as well. Lowering your blood cholesterol level can slow, stop, or even reverse the buildup of plaque. Cholesterol lowering can reduce the cholesterol content in unstable plaques to make them more stable and less prone to rupture.
One of the most important ways to have healthier arteries is to make lifestyle changes. Adopt a healthy diet, balance healthful eating with regular physical activity, don't smoke, and lose weight if you are overweight. If you have high blood cholesterol, high blood pressure or diabetes, follow your treatment plan. Making lifestyle changes can also help control these health problems.
Yes. You can't do anything about your genes, your gender or your age, but you can adopt a healthy lifestyle.
Maintain a healthy weight and avoid weight gain as you get older.
Get plenty of regular exercise—at least 30 minutes a day, most days of the week.
Eat a healthy diet low in saturated fat and rich in fruits and vegetables.
If you have high blood cholesterol or high blood pressure, you may need medicine to help lower it. Stick to your treatment plan.
If you have diabetes, follow your treatment plan.
If you smoke, stop.
If stress is a problem, find ways to reduce or control it.
Talk to your health care provider about what you can do to lower your risks for atherosclerosis and cardiovascular disease.
For More Information...
For more information on atherosclerosis, contact the National Women's Health Information Center (NWHIC) at (800) 994-9662 (WOMAN) or the following organizations:
National Heart, Lung, and Blood Institute (NHLBI)
Phone: (800) 575-9355 (Information Line)
Internet Address: http://www.nhlbi.nih.gov/index.htm
National Institute of Neurological Disorders and Stroke
Phone: (800) 352-9424
Internet Address: http://www.ninds.nih.gov/
American Heart Association (AHA)
Phone: (800) 242-8721 (Heart & Stroke Information) (800) 793-2665 (Publications)
Internet Address: http://www.americanheart.org/
National Stroke Association
Internet Address: http://www.stroke.org/
The Academy of Family Physicians
Internet Address: http://www.familydoctor.org/
American College of Cardiology
Internet Address: http://www.acc.org/
All material contained in the FAQs is free of copyright restrictions, and may be copied, reproduced, or duplicated without permission of the Office on Women's Health in the Department of Health and Human Services; citation of the source is appreciated.
Publication date: March, 2002
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