Atherosclerosis
Atherosclerosis, sometimes referred to as hardening of the arteries, is a gradual process in which cholesterol and scar tissue accumulate to form a fatty deposit or plaque that clogs the blood vessels. Atherosclerosis results in diminished blood flow to an affected organ.
If you smoke or have diabetes, you have an especially high risk for atherosclerosis and developing peripheral arterial disease (PAD). Other risk factors include high blood pressure and elevated cholesterol. Atherosclerosis is a systemic problem that can affect multiple organs and manifest itself in a variety of ways.
Symptoms depend on which arteries are involved. For instance, if the arteries to the legs are involved, patients experience leg cramps and calf pain while walking (intermittent claudication). If the arteries in the neck develop blockages, patients are at risk of stroke. If the arteries to the kidneys are involved, patients can develop uncontrolled hypertension and kidney insufficiency. If the narrowing occurs in the arteries that feed the intestines, patients develop severe abdominal pain after eating.
Specific treatment for atherosclerosis will be determined by your doctor based on a number of factors. These include age, overall health and medical history, the extent and location of the problem area and your signs and symptoms. Treatment may include:
- Modification of risk factors: Risk factors that may be modified include smoking, elevated cholesterol levels, elevated blood glucose levels, lack of exercise, poor dietary habits and elevated blood pressure
- Medications, such as:
- Antiplatelet drugs (which decrease the ability of platelets in the blood to stick together and cause clots)
- Anticoagulants (often described as "blood thinners")
- Antihyperlipidemics that lower lipids (fats) in the blood, particularly low density lipid (LDL) cholesterol. This class of medication includes statins, bile acid sequestrants and nicotinic acid (niacin).
- Antihypertensives, or medications used to lower blood pressure
- Coronary angioplasty: With this procedure, a balloon is used to create a bigger opening in the vessel to increase blood flow. Treatments in this category might include: balloon angioplasty, atherectomy, laser angioplasty, or coronary artery stent.
- Coronary artery bypass: Most commonly referred to as simply "bypass surgery," this surgery is often performed in people who have angina (chest pain) due to coronary artery disease where plaque has built up in the arteries. Surgery is sometimes necessary either due to the location of the blockage or in cases where less invasive approaches either have not or would not be able to adequately addressed the problem. During the surgery, a bypass is created by grafting a piece of a vein above and below the blocked area of a coronary artery, enabling blood to flow around the obstruction. Veins are usually taken from the leg, but arteries from the chest or arm may also be used to create a bypass graft.