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What is Arteriosclerosis?
The term arteriosclerosis is often misused by the lay person; its correct full name is 'arteriosclerosis obliterans' and, in a strict medical sense, it defines the formation of plaques of cholesterol, platelets, fibrin, and other substances on the arterial walls, and leads to progressive degrees of blockage of the arterial circulation.
Known causes
The known causes of these plaques include smoking, high cholesterol levels (diet), high blood pressure as well as hereditary susceptibility (ie. strong family history of similar disease) and diabetes . If the arteries supplying the heart is called Coronary Artery Disease (CAD) and may cause 'Angina' (pain in the chest) and even an heart attack.
There are various possible causes for arteriosclerosis but by far the most common cause is the deposition of plaques of cholesterol (known as atherosclerosis), platelets and other substances within the arterial walls. Sometimes the build-up is very gradual, but in other cases the build-up is suddenly increased as a chunk of matter breaks off and suddenly blocks the already narrowed opening. In this case, diet is a primary factor to be considered (see below - Diet & Nutrition).
Causative Factors summarised: - There are several factors which may influence the build-up of plaque on the arterial walls. These include:-
1. Hereditary factors (ie. a strong family history of heart attacks)
2. Being male - females are less likely to suffer arteriosclerosis, probably because the female hormones offer some degree of protection.
3. Cigarette smoking and high blood pressure - both of which are reversible in most cases.
4. High blood cholesterol levels (both total and low density types).
5. Risk increases with age.
6. Certain intense, hostile or time- pressured personality types (so- called type A), inactive lifestyle, and high cholesterol diets.
Symptoms
A blockage in the arteries can occur anywhere in the body although the most common site is the arteries of the legs, either high in their course in the pelvis, or further down in the calf. Once blockage becomes severe, exertion of the muscles which receive blood supply from the affected artery causes pain due to insufficient blood. This is known as intermittent claudication and often causes an aching pain in the muscle which is relieved by rest and worsened by resumed physical activity. If pain is present even at rest, the problem is serious and unless treated, could necessitate amputation of the limb.
In the advanced stages, the limb becomes cold, pale, discoloured, and sores form on the skin from gangrene to the area involved. Infection may set in, and ultimately the leg must be amputated to save the life of the patient.
It is unusual for other areas to be affected without the legs being involved, but those with arteriosclerosis in the leg, have a much higher incidence of heart disease, stroke, and kidney artery blockage.
Where coronary arteries are affected, this will cause angina (chest pain) or even heart attack. If the arteries in the brain are affected, this can lead to a stroke.
Diagnosis
Apart from the above symptoms, arteriosclerosis has other typical signs including absent pulses and poor skin filling from capillaries which are compressed. Ultrasound tests may further confirm the diagnosis, but anarteriography in which a dye is injected into the larger arteries and traced with X-rays is the most reliable test.
Conventional Treatment
Typical medical treatment ranges from light exercise (if no major symptoms are evident) and drug therapy to surgery. Bypass grafts made of synthetic material is inserted in place of the blocked segments; alternatively, the area involved may be surgically dilated.
If the blockage is in many smaller vessels instead of one or a few large vessels, surgery is considered inappropriate but if a single severe blockage is present, a procedure called "balloon dilatation" is sometimes advised. In this mode of treatment, a tube is inserted into the artery under x-ray guidance, and at the area of obstruction a tiny balloon is inflated to relieve the obstruction.
Drug Therapy
Medications are often prescribed to control the symptoms relating to arteriosclerosis. The oldest and most common agents are the nitrates, derivatives of nitroglycerine. They include nitroglycerine, isosorbide, and similar agents. Newer forms include long acting oral agents, plus skin patches which release a small amount through the skin into the bloodstream over a full day. They act by reducing the burden of blood returning to the heart from the veins and also by dilating the coronary arteries themselves. Nitrates are considered by many to be the mainstay of medical therapy for angina, and are used both for treatment of symptoms as well as prevention of anticipated symptoms. They are considered to be effective for relief and prevention of angina, and sometimes for limiting the size of a heart attack. However, there are side effects associated with these drugs including headaches, dizziness, postural hypotension and tachycardia (1).
The second group of drugs are called "beta blockers" for their ability to block the activity of the beta receptors of the nervous system. The beta receptors cause blood pressure elevation, rapid heart rate, and forceful heart contractions. When these actions are decreased, the heart needs less blood, and thus angina and even the extent of a heart attack may be reduced. Again, these drugs have known possible side effects including gastro-intestinal disturbances and incredibly, heart failure! (2).
The latest group of drugs for coronary disease is called the calcium channel blockers. Calcium channels refer to the areas of the membranes of heart and other cells where calcium flows in and out, reacting with other chemicals to modulate the force and rate of contractions. In the heart, they can reduce the force and rate of contractions and electrical excitability, thereby having a calming effect on the heart. These drugs also have known side effects including oedema, liver and kidney damage, headache, nausea and rashes (3).
Bypass Surgery
Experts who reviewed bypass surgery over a 15 year period concluded that, in most cases, the operation has not been shown to save lives. In fact, they found that, quite the contrary, there is a 15% (or greater) risk of brain damage following coronary bypass surgery(4).
Prognosis
If arteriosclerosis is left untreated it can be fatal by leading to a stroke or heart attack (where the coronary arteries are affected.) Especial caution is needed if a patient is also diabetic because the disease can progress very rapidly in diabetic patients.
What is Arteriosclerosis?
The term arteriosclerosis is often misused by the lay person; its correct full name is 'arteriosclerosis obliterans' and, in a strict medical sense, it defines the formation of plaques of cholesterol, platelets, fibrin, and other substances on the arterial walls, and leads to progressive degrees of blockage of the arterial circulation.
Known causes
The known causes of these plaques include smoking, high cholesterol levels (diet), high blood pressure as well as hereditary susceptibility (ie. strong family history of similar disease) and diabetes . If the arteries supplying the heart is called Coronary Artery Disease (CAD) and may cause 'Angina' (pain in the chest) and even an heart attack.
There are various possible causes for arteriosclerosis but by far the most common cause is the deposition of plaques of cholesterol (known as atherosclerosis), platelets and other substances within the arterial walls. Sometimes the build-up is very gradual, but in other cases the build-up is suddenly increased as a chunk of matter breaks off and suddenly blocks the already narrowed opening. In this case, diet is a primary factor to be considered (see below - Diet & Nutrition).
Causative Factors summarised: - There are several factors which may influence the build-up of plaque on the arterial walls. These include:-
1. Hereditary factors (ie. a strong family history of heart attacks)
2. Being male - females are less likely to suffer arteriosclerosis, probably because the female hormones offer some degree of protection.
3. Cigarette smoking and high blood pressure - both of which are reversible in most cases.
4. High blood cholesterol levels (both total and low density types).
5. Risk increases with age.
6. Certain intense, hostile or time- pressured personality types (so- called type A), inactive lifestyle, and high cholesterol diets.
Symptoms
A blockage in the arteries can occur anywhere in the body although the most common site is the arteries of the legs, either high in their course in the pelvis, or further down in the calf. Once blockage becomes severe, exertion of the muscles which receive blood supply from the affected artery causes pain due to insufficient blood. This is known as intermittent claudication and often causes an aching pain in the muscle which is relieved by rest and worsened by resumed physical activity. If pain is present even at rest, the problem is serious and unless treated, could necessitate amputation of the limb.
In the advanced stages, the limb becomes cold, pale, discoloured, and sores form on the skin from gangrene to the area involved. Infection may set in, and ultimately the leg must be amputated to save the life of the patient.
It is unusual for other areas to be affected without the legs being involved, but those with arteriosclerosis in the leg, have a much higher incidence of heart disease, stroke, and kidney artery blockage.
Where coronary arteries are affected, this will cause angina (chest pain) or even heart attack. If the arteries in the brain are affected, this can lead to a stroke.
Diagnosis
Apart from the above symptoms, arteriosclerosis has other typical signs including absent pulses and poor skin filling from capillaries which are compressed. Ultrasound tests may further confirm the diagnosis, but anarteriography in which a dye is injected into the larger arteries and traced with X-rays is the most reliable test.
Conventional Treatment
Typical medical treatment ranges from light exercise (if no major symptoms are evident) and drug therapy to surgery. Bypass grafts made of synthetic material is inserted in place of the blocked segments; alternatively, the area involved may be surgically dilated.
If the blockage is in many smaller vessels instead of one or a few large vessels, surgery is considered inappropriate but if a single severe blockage is present, a procedure called "balloon dilatation" is sometimes advised. In this mode of treatment, a tube is inserted into the artery under x-ray guidance, and at the area of obstruction a tiny balloon is inflated to relieve the obstruction.
Drug Therapy
Medications are often prescribed to control the symptoms relating to arteriosclerosis. The oldest and most common agents are the nitrates, derivatives of nitroglycerine. They include nitroglycerine, isosorbide, and similar agents. Newer forms include long acting oral agents, plus skin patches which release a small amount through the skin into the bloodstream over a full day. They act by reducing the burden of blood returning to the heart from the veins and also by dilating the coronary arteries themselves. Nitrates are considered by many to be the mainstay of medical therapy for angina, and are used both for treatment of symptoms as well as prevention of anticipated symptoms. They are considered to be effective for relief and prevention of angina, and sometimes for limiting the size of a heart attack. However, there are side effects associated with these drugs including headaches, dizziness, postural hypotension and tachycardia (1).
The second group of drugs are called "beta blockers" for their ability to block the activity of the beta receptors of the nervous system. The beta receptors cause blood pressure elevation, rapid heart rate, and forceful heart contractions. When these actions are decreased, the heart needs less blood, and thus angina and even the extent of a heart attack may be reduced. Again, these drugs have known possible side effects including gastro-intestinal disturbances and incredibly, heart failure! (2).
The latest group of drugs for coronary disease is called the calcium channel blockers. Calcium channels refer to the areas of the membranes of heart and other cells where calcium flows in and out, reacting with other chemicals to modulate the force and rate of contractions. In the heart, they can reduce the force and rate of contractions and electrical excitability, thereby having a calming effect on the heart. These drugs also have known side effects including oedema, liver and kidney damage, headache, nausea and rashes (3).
Bypass Surgery
Experts who reviewed bypass surgery over a 15 year period concluded that, in most cases, the operation has not been shown to save lives. In fact, they found that, quite the contrary, there is a 15% (or greater) risk of brain damage following coronary bypass surgery(4).
Prognosis
If arteriosclerosis is left untreated it can be fatal by leading to a stroke or heart attack (where the coronary arteries are affected.) Especial caution is needed if a patient is also diabetic because the disease can progress very rapidly in diabetic patients.
The use of Aspirin
Aspirin has been shown to help thin the blood and thereby reduce pressure on the heart and helping to prevent heart disease, BUT at the same time, it also increases the likelihood of arterial stroke (5).
Fortunately there are effective alternatives worth considering. For details of research relating to Arteriosclerosis &
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