Hardening of the Arteries: Understanding Atherosclerosis and Its Impact on Heart Health

Atherosclerosis is a hardening and narrowing of the arteries, i.e., the blood vessels that transport blood away from the heart. It has been going on for years or decades. The narrowing of the arteries causes reduced blood flow to organs and parts of the body. Despite decades of research, we still need to figure out exactly why arteriosclerosis develops. It is agreed that there is a predisposition to arteriosclerosis and its consequences – heart attack stroke. It is also known that women have natural protection from the female sex hormones when they are younger, but this protection decreases with the onset of menopause.

inheritance sex-dependent

While searching for the gene responsible for hardening the arteries, a scientist from the University of Leipzig made an astonishing discovery while researching two strains of mice: Arteriosclerosis can only be inherited by the opposite sex. ”The transmission of the gene responsible for arteriosclerosis depends on the gender of the parent generation.

If a male offspring carries this gene, the mother must have previously held this gene. Conversely, a female descendant with this gene requires a corresponding male ancestor”, according to the scientist Dr. Teupser. ”So if we want to find out how arteriosclerosis and thus heart attack or stroke can be inherited in humans, we have to consider the line of inheritance.”

 

The onset is insidious and unrecognized.

Atherosclerosis does not develop overnight. It can be 20 to 40 years before the first symptoms appear, but they are already severe. These include, for example, circulatory disorders in the legs, since the narrowed arteries are poorly supplied with oxygen, or a narrowing of the coronary arteries, which leads to angina pectoris. Other symptoms include declining brain function, such as memory problems or dizziness.

If the hardening of the arteries progresses, an arterial occlusion can lead to a total interruption of the blood supply and, thus, to a lack of oxygen in an organ. The heart, brain and legs are particularly frequently affected by arteriosclerotic diseases.

Risk factors for the development of arteriosclerosis

Atherosclerosis only becomes a disease through factors that accelerate its natural course. This includes:

• High blood pressure because it puts more pressure on the blood vessels
• Diabetes mellitus
• sedentary lifestyle, overweight
• High-fat, unbalanced diet
• Stress
• Smoking, as nicotine narrows blood vessels
• High uric acid level
• Elevated levels of fibrinogen (increased blood clotting)
• High homocysteine ​​level
• vitamin deficiencies
• Cholesterol levels are too high because cholesterol is deposited in the blood vessels

Patients with these risk factors should be regularly checked by their doctor.

 

development of arteriosclerosis

The vessels are lined on the inside with a smooth, thin layer of cells – the intima. If specific damaging influences last long, this lining gets small cracks. This activates the body’s defence system and sends its helpers – similar to a wound. But this repair is not optimal: liquid penetrates the vessel wall, a slight swelling develops, and blood cells, fat, and calcium build-up.

The vessel’s inner wall thickens as a protective reaction, and a so-called atheroma has developed. The term comes from the Greek and means “porridge” because the resulting thickening looks similar.

Over time, more and more lime is deposited at this point and the vessel wall becomes hard. A so-called plaque has formed. From this point on, one speaks of arteriosclerosis. This narrowing of the blood vessels is noticed for a short time because blood vessels can widen and thus keep the blood flow constant up to a specific limit.

What is happening in the heart?

Such processes also occur in the small arteries supplying the heart with nutrients. Circulatory disorders are usually only noticed when the vessel is only one-third open. The typical symptoms then appear with heavier loads: shortness of breath and pain in the legs or chest.

If the constriction has developed very slowly, the blood vessel system can form bypass circuits (so-called collaterals ). The body uses existing vessels to continue to supply the heart muscle with blood via this “diversion”. If such bypass circuits are present, there can be no symptoms despite a blocked artery in the heart.

Small cause – significant effect

It becomes critical when small particles detach from the deposits in the vessel wall or when the entire plaque breaks open. Then, the vessel can suddenly be blocked entirely. This congestion cuts off the blood flow to the vascular section behind it. The cells that are usually supplied with blood die off.

If the whole thing happens to the heart, a heart attack occurs, and the blockage of cerebral vessels leads to a stroke  – with severe personal consequences.

Recent studies show that the greatest danger is not from the thickest deposits but small, soft plaques. Because they are more unstable and have thinner skin and fatty cores, sudden physical exertion or fluctuations in blood pressure can rupture the thin skin, often resulting in a blood clot.

 

Preventive measures against atherosclerosis

Everyone indeed gets this vascular disease with increasing age. A healthy lifestyle, however, develops much more slowly. Our vessels have been designed by nature for many decades to be permeable for blood. It is known that some people around 80 years old still have youthful, smooth inner walls of the arteries, while in some forty-year-olds, the blood has to fight its way through a landscape of craters.

If you want to stay healthy, you must do something for it – and you should know what you can do. The best prevention is a sensible diet and sufficient exercise. In addition to prevention, the avoidance or treatment of risk factors  is also of great importance:

• regular monitoring of blood pressure and cholesterol levels
• if the cholesterol level is high, pay attention to a low-cholesterol diet, i.e. reduce the amount of butter, eggs and meat
• People with diabetes should always make sure that their sugar levels are set correctly
• Quit or at least reduce smoking
• If you are overweight, you should try to lose weight

Arteriosclerosis: when to see a doctor?

Anyone who belongs to the particular risk groups for arteriosclerosis should be examined regularly by a doctor to be on the safe side. It is also essential to pay attention to your body’s warning signals: numb legs or pain when walking can indicate arteriosclerosis and should, therefore, be checked by a doctor immediately.

This can determine where the symptoms come from by palpation, blood pressure measurement and, if necessary, imaging procedures. A so-called angiography can be used, for example, to make blockages in veins visible using a contrast medium.

treatment of atherosclerosis

Arteriosclerosis is basically not curable. However, the course of the disease can be significantly delayed with the right therapy. The balloon catheter is one of the measures used to treat arteriosclerosis. In the event of a narrowing of the artery, this is inflated like a balloon and expands the narrowed artery so that the blood can flow again. In addition, a so-called stent can be used to treat arteriosclerosis. A stent is a small metal mesh that spreads the artery and keeps it open like a support.

If it is not enough to widen the narrowed arteries, an operation to create a so-called bypass is required, in which the bloodstream is diverted. Either endogenous or artificial veins are used for this purpose.

 Drugs used to treat hardening of the arteries include drugs that lower blood pressure or cholesterol. Acetylsalicylic acid is sometimes prescribed to prevent the platelets from sticking to the wall of the blood vessel or themselves and forming a blood clot.

 

Reduce risk factors

All measures to treat arteriosclerosis should always be accompanied by appropriate elimination of the causes, i.e. a change in lifestyle or treatment of the underlying disease. Otherwise, there is a risk of renewed narrowing of the vessels and the corresponding consequences of arteriosclerosis, such as a stroke or heart attack.