Hardening of the Arteries

Arteriosclerosis is a hardening and narrowing of the arteries, the blood vessels that carry blood away from the heart, that occurs over years or decades. The narrowing of the arteries causes reduced blood flow to organs and parts of the body. Despite decades of research, it is still not known exactly why arteriosclerosis develops. It is generally accepted that there is a predisposition to arteriosclerosis and its consequences – heart attacks and strokes. It is also known that women in younger years have a natural protection by the female sex hormones, which, however, decreases with the onset of menopause.

Inheritance dependent on sex

While searching for the gene responsible for arteriosclerosis, a scientist at the University of Leipzig made an astonishing discovery during research on two strains of mice: atherosclerosis can only be inherited from the opposite sex. ”The transmission of the gene responsible for arteriosclerosis depends on the sex of the parent generation. If a male offspring carries this gene, the mother must have carried it previously. Conversely, a female offspring carrying this gene requires a corresponding male ancestor,” said Dr. Teupser, a scientist. ”So if we want to figure out in humans how atherosclerosis, and thus heart attack or stroke, can be inherited, we have to look at the line of inheritance.”

The onset is insidious and unrecognized

Atherosclerosis does not develop overnight. Before the first symptoms appear, 20 to 40 years can pass – but they are then already of a serious nature. These include, for example, circulatory problems in the legs because the narrowed arteries are poorly supplied with oxygen, or a narrowing of the coronary arteries that leads to angina. Other symptoms may include a decline in brain function, for example memory problems or dizziness. If the arteriosclerosis progresses further, an arterial occlusion can lead to a total interruption of the blood supply and thus to a lack of oxygen to an organ. The heart, brain and legs are particularly frequently affected by arteriosclerotic disease.

Risk factors for the development of atherosclerosis

Arteriosclerosis first becomes a disease due to factors that accelerate its natural progression. These include:

  • High blood pressure, because this exposes the vessels to greater pressure loads.
  • Diabetes mellitus
  • Lack of exercise, overweight
  • High-fat, unbalanced diet
  • Stress
  • Smoking, as nicotine constricts the blood vessels
  • High uric acid level
  • Increased fibrinogen level (increased blood clotting).
  • High homocysteine level
  • Vitamin deficiencies
  • Too high cholesterol, because cholesterol is deposited in the vessels

Patients with these risk factors should have regular checkups with their doctors.

Development of atherosclerosis

The vessels are lined on the inside with a smooth, thin layer of cells – the intima. If certain damaging influences persist over a long period of time, this lining develops small cracks. The body’s own defense system is activated by this and sends its helpers – similar to a wound. But this repair does not proceed optimally: fluid penetrates the vessel wall, a small swelling develops and blood cells, fat and calcium settle. As a protective reaction, the inner wall of the vessel thickens and a so-called atheroma is formed. The term comes from the Greek and means “flour paste”, because this is what the thickening looks like. Over time, more and more lime is deposited at this point and the vessel wall becomes hard. A so-called plaque is formed. From this point on, one speaks of arteriosclerosis. This narrowing of the blood vessel is not noticed for a long time, because blood vessels can widen and thus keep the blood flow constant up to a certain limit.

What happens to the heart?

Such processes also take place in the small arteries that supply the heart with nutrients. There, circulatory disturbances are usually not noticed until the vessel is only one-third open. Then the typical symptoms occur during heavy exertion: Shortness of breath and pain in the legs or chest.If the narrowing has developed very slowly, the vascular system can form bypasses (so-called collaterals). The body uses already existing vessels to continue supplying blood to the heart muscle via this “bypass”. If such bypass circuits are present, symptoms may not occur despite a blocked vessel in the heart.

Small cause – big effect

It becomes critical when small particles break off from the deposits in the vessel wall or the entire plaque breaks open. Then the vessel can suddenly become completely blocked. This blockage cuts off the blood supply to the section of the vessel behind it. The cells that are normally supplied with blood die. If the whole thing happens to the heart, a heart attack results; blockage of brain vessels leads to a stroke – with serious personal consequences. Recent studies show that the greatest danger comes not from the thickest deposits, but from small, soft plaques. This is because these are more unstable, have thinner skin and a more fatty core. Abrupt physical exertion or fluctuations in blood pressure can cause the thin skin to rupture, often resulting in a blood clot.

Preventive measures against arteriosclerosis.

It is true that everyone gets this vascular disease as they age. However, it develops much more slowly with a healthy lifestyle. Our vessels are naturally designed to be passable for blood for many decades. Some people who are around 80 years old are known to still have youthfully smooth inner arterial walls, whereas in some forty-year-olds the blood has to fight its way through a cratered landscape. So if you want to stay healthy, you have to do something about it – and you should know what you can do. The best prevention is a sensible diet and sufficient exercise. But in addition to prevention, avoiding or treating risk factors is also very important:

  • Regular control of blood pressure and cholesterol levels.
  • With increased cholesterol levels pay attention to low cholesterol diet, that is, butter, eggs, reduce the amount of meat.
  • Diabetics should always make sure that their sugar levels are set correctly
  • Stop smoking or at least reduce
  • Overweight people should definitely aim for weight reduction

Arteriosclerosis: when to see a doctor?

Anyone who belongs to the special risk groups for arteriosclerosis should, to be on the safe side, be examined regularly by a doctor. In addition, it is important to pay attention to the warning signs of his body: Numbness in the legs or pain when walking can indicate arteriosclerosis and should therefore be checked immediately by a doctor. He or she can determine the origin of the symptoms by palpation, blood pressure measurement and, if necessary, imaging procedures. By means of a so-called angiography, for example, blockages in veins can be made visible with the help of a contrast medium.

Treatment of arteriosclerosis

Arteriosclerosis is fundamentally incurable. However, with the right therapy, the progression of the disease can be significantly delayed. Among the measures used to treat arteriosclerosis is the balloon catheter. This is inflated like a balloon in the event of a vascular stenosis and expands the narrowed artery so that the blood can flow again. In addition, a so-called stent can be used in the treatment of arteriosclerosis. A stent is a small metal mesh that acts like a brace to stretch the artery and keep it open. If it is not enough to widen the narrowed arteries, surgery is required to create a so-called bypass, in which the bloodstream is diverted. Either the body’s own or artificial veins are used for this purpose. Medication used to treat arteriosclerosis includes drugs to lower blood pressure or cholesterol. Acetylsalicylic acid is also sometimes prescribed to prevent platelets from sticking to the vessel wall or to themselves and forming a blood clot.

Reduce risk factors

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