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Atherosclerosis (often spelled athersclerosis) is a disease of the arteries in which a fatty/wax-like substance (plaque) is deposited on the inside of the arterial walls. As this substance builds up, it causes the arteries to narrow. Over time, this narrowing prevents the blood from flowing properly through the arteries, giving rise to congestive heart failure, heart attack or stroke.
Atherosclerosis plaque itself consists of fatty substances, cholesterol, cellular waste products and calcium. If part of this plaque breaks away, it can travel in the bloodstream to a point where the artery is narrow enough for the plaque to completely block it. If the affected artery feeds the heart, a heart attack may result, and if it feeds the brain, a stroke may result.
Atherosclerosis also causes high blood pressure (hypertension). As the blood is forced through the narrowed arteries, it exerts more pressure on the walls. This also increases the risk of stroke and heart attack. Angina (chest pain) is another condition caused by narrowing of the arteries (atherosclerosis).
Atherosclerosis Progression
Atherosclerosis is a slow, complex disease that starts in childhood. As a person ages, atherosclerosis is likely to worsen as more plaque is deposited in the arteries. In some people -even those in their 30s- atherosclerosis progresses quickly.
While the exact cause of atherosclerosis remains unknown, many researchers believe that the buildup of plaque begins when the innermost layer (endothelium or intima) of the artery becomes damaged by free radical attack (oxidation) and associated inflammation. Either as the body’s attempt to repair this damage, or simply because they become trapped, fatty substances (such as LDL and vLDL cholesterol) and minerals (such as calcium and other metals) collect at the site of the damage forming a plaque that narrows the affected artery opening.
Note: Arteries carry blood rich in oxygen and nutrients to the tissues of the body, providing the fuel needed by the cells to function properly and repair effectively. If the arteries narrow, such as is the case with atherosclerosis, less nutrients and oxygen will be delivered to the tissues associated with those narrowed arteries. Lowered nutrient and oxygen supply leads to progressive cell death and loss of tissue function.
How Common Is Atherosclerosis?
Just how much of the population has atherosclerosis is hard to determine. However, approximately one in six North Americans have cardiovascular disease in some form or another, and most of these diseases begin with atherosclerosis.
Recently, many heart experts have been examining the role played by inflammation in the development of atherosclerosis (and therefore, more advanced stages of heart disease). Many now believe that there is a link between arterial damage, the inflammatory process and coronary atherosclerosis. One of the indications of inflammation in the arteries is the presence of a substance called “C-reactive protein” (CRP) in the blood. Levels of this marker (C-reactive protein) are elevated when heart disease is present because the plaque in diseased arteries typically contains inflammatory cells. In a survey of 388 British men aged 50-69, the prevalence of coronary artery disease increased 1.5 fold for each doubling of CRP levels.
It follows that reduction of damage and inflammation within the arteries may inhibit plaque buildup and thereby reduce risk of atherosclerosis and associated heart conditions.
Warning Signs
The specific symptoms of atherosclerosis depend on what arteries are affected.
When arteries to the brain are affected, atherosclerosis warning signs include:
- Headaches
- Dizzy spells
- Ringing of ear
- Memory problems
- Poor concentration
- Mood changes
When arteries to the heart are affected, atherosclerosis warning signs include:
- Chest pain (angina)
- Elevated blood pressure
When arteries to the arms or legs are affected, atherosclerosis warning signs include:
- Aching muscles
- Fatigue
- Cramping pains in the calves (intermittent claudication)
- Pain in the hips and thighs (may be present depending on which arteries are blocked).
Laboratory Tests Assess Heart Attack Risk
Heart attack risk can be assessed by measuring a wide range of markers,
including: CRP (c-reactive protein), homocysteine, transferrin, total cholesterol, HDL and LDL, fibrinogen (a globulin that affects blood coagulation), and apolipoproteinB (apoB) and apolipoproteinA-1 (apoA-1) levels, as well as apo ratios – the higher ApoB/APO A-1 ratio may signal an increased risk of cardiovascular disease. (apoB carries LDL and VLDL cholesterol) (apoA-1 carries HDL cholesterol)
One comprehensive test that can assess all these important heart health predictors from just one blood sample is called the Comprehensive Cardiovascular Report (CCR), and it’s available from Great Smokies Diagnostic Laboratories.
Talk to your doctor about requesting the CCR test, or a similar type of test, to get an overall picture of your heart health risk, because simply writing a prescription for statins to address individual symptoms is a tunnel-vision treatment.
- Scientific opposition to the cholesterol hypothesis
- Statin Drugs – A Critical Review of the Risk vs Benefit Research
Mendall MA, Patel P., Ballam L., et al. C-reactive protein and its relation to cardiovascular risk factor: A population based cross sectional study. BMJ. 1996;312:1061-1065.
Atherosclerosis Risk Factors and Prevention
Since atherosclerosis precedes or accompanies a number of cardiovascular and circulatory conditions (stroke, high blood pressure, congestive heart failure, angina, heart attack, etc.) the risk factors for all these diseases tend to parallel those for atherosclerosis. Atherosclerosis risk factors include:
Factors you can influence:
- elevated C-reactive protein” (CRP) levels in the blood.
- elevated cholesterol levels, particularly LDL (bad) cholesterol.
- Elevated blood triglyceride levels.
- being a smoker or being exposed to tobacco smoke.
- having high blood pressure.
- diet – eating fatty foods (particularly those rich in hydrogenated oils) and foods that are overly processed are believed to contribute towards heart disease.
- Having diabetes.
- living a sedentary lifestyle.
- Being overweight.
- dealing poorly with ongoing stress.
Factors you can’t influence:
- your age: over 45 for men and over 55 for women.
- family medical history of heart attack or stroke before age 65, angina, or the tendency to develop high blood cholesterol or blood pressure.
- ethnicity: African, South Asian and First Nation populations are at greater risk.
Wellness Tips
While some risk factors for heart disease cannot be addressed (your age, family history and ethnicity), many of the contributing factors are linked to the lifestyle you choose to lead. Here are the primary ways in which you can reduce your risk of atherosclerosis and other forms of heart disease.
If you are a smoker, quit! Many excellent products to help you stop smoking may be found at your local pharmacy. The Internet is also a valuable source of information on smoking cessation.
If you are overweight, see your doctor about starting a weight-reduction program. Consuming a prudent diet, combined with regular exercise, will help those pounds melt away.
Get exercising. Studies show that even moderate exercise (a half-hour walk once a day, six days a week), will help balance cholesterol levels in the long run, reduce triglyceride levels and help you lose weight. Regular exercise can also help you to manage stress and improve the efficiency of your heart, lungs and muscles.
Improve your diet. Add hemp oil, high-lignan flax oil and pumpkin oil and more fatty fish like salmon or sardines to your diet, which contain health promoting omega 3 fatty acids – studies have shown that diets rich in omega-3 fatty acids may lower triglyceride levels, reduce platelet aggregation or clumping, and improve the functioning of cells that line the heart and blood vessels; add fresh fruit and vegetables (organic whenever possible); eat garlic, turmeric and ginger as they have proven heart benefits; eat more legumes (beans, peas)
Get rid of “bad fat”. Try to eliminate your intake of the heart disease-promoting hydrogenated oils (trans-fatty acids). Cut down on foods rich in animal fats, particularly fatty meats (beef, pork) and high-fat dairy products.
Eat smaller meals and incorporate high-quality protein snacks throughout the day to aid in increasing insulin sensitivity. This is especially important for people who have been diagnosed with diabetes. When blood sugar is not kept in control the excess blood sugar (glucose) actually causes damage to the artery lining (glycosylation) so it is essential to keep your blood sugar as level as possible.
Take a coenzyme Q10 (CoQ10) supplement. CoQ10 is an important antioxidant that the heart uses to protect itself from the damaging compounds by the cells during the process of metabolism. As we age, the amount of CoQ10 produced by the heart diminishes. Taking certain drugs (e.g. cholesterol lowering drugs such as HMG CoA reductase inhibitors) also lower heart-protective CoQ10 levels.
Make sure you get enough calcium. Cutting down on fat-rich dairy products can impact your intake of calcium. This mineral is essential for the cardiovascular system to function normally. Recent studies show that people who have enough calcium in their diet are less likely to develop high blood pressure, a key risk factor for heart disease and stroke. If you are not getting enough calcium, consider taking a supplement. (Better calcium supplements also contain magnesium and vitamin D to aid absorption and maintain calcium/magnesium balance.) The recommended daily intake of elemental calcium is 1,200 mg a day for adult women, between 1,500 and 1,800 mg a day if you are pregnant or lactating, and 1,500 mg a day if you have passed menopause. Men over 19 should take 1,000 mg calcium a day.
Make sure you get enough magnesium. Not eating many grains and green vegetables can impact your intake of magnesium. Magnesium is another mineral that is essential for the cardiovascular system to function normally. Magnesium is necessary for relaxation of the smooth muscles that surround your blood vessels. Recent studies show that people who have enough magnesium in their diet are less likely to develop high blood pressure, a key risk factor for heart disease and stroke. If you are not getting enough magnesium, consider taking a supplement.
Make sure you get enough B vitamins. The B vitamins folic acid, B6 and B12 in particular reduce homocysteine levels in the blood. Elevated homocysteine levels may increase the risk of developing arteriosclerosis. B vitamins are found in fruits and green, leafy vegetables and other wholesome foods. You may wish to take a multi-vitamin to make sure adequate levels of these B vitamins are being consumed daily. Rich sources of folic acid (folate) include citrus fruits, tomatoes, leafy green vegetables, and pinto, navy and kidney beans.
Learn to cope with stress. Mismanaged stress contributes significantly towards high blood pressure and heart disease. Take a stress management course or read up on how to manage the stress in your life.
Consult your doctor / healthcare professional about new food-based non-drug products formulated to help improve quality of life such as Recovery with Nutricol. Recovery has been developed to improve circulation to tissues, speed repair and slow or halt tissue damage.
Look into chelation therapy to find new ways to unblock the arterial wall and to improve circulation. Contrary to the opinions expressed by many medical professionals, the data proving the effectiveness of chelation therapy is extensive. Chelation therapy helps to improve the health of your arteries.
Get hemochromatosis treated if you are diagnosed to have excessive iron blood levels due to the condition hemochromatosis talk to your doctor about ways to normalize your iron levels so that excessive blood vessel damage does not occur.