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Atherosclerosis is hardening of the medium and large arteries with plaques. The ‘plaque’ refers to deposits of fats, cellular debris (garbage) and irregular growth of normal cells of the artery. The artery then becomes narrower, and less flexible, allowing less blood to flow. Some tissues may not receive ample blood supply needed, becoming ischemic: lacking blood and oxygen. Sometimes the area of plaque will break off, and form blood clots. This sets the stage for such situations like heart attacks and strokes. Atherosclerosis is the basis for many different types of heart disease and is known under different names: the general term cardiovascular disease (CVD), when it involves blood vessels to the heart it is called coronary artery disease (CAD), when there is a decrease in blood and oxygen it is called ischemic heart disease- (IHD), when it involves blood flow to the abdomen, arms and legs it is peripheral artery disease – (PAD) or intermittent claudication-specially involving blood flow to the legs and producing pain during exercise, stroke and transient ischemic attacks (TIA), heart attacks or myocardial infarction (MI), high blood pressure and angina. Scientists believe that atherosclerosis happens during the course of life; for instance, children may have areas of atherosclerosis at various parts of the body not associated with disease, and not commonly found in adults. But it is the progression of the disease during adult years that can be treated and prevented with a healthy lifestyle and diet. There are a number of risk factors for heart disease, and many can be changed to reduce your risk of disease. High cholesterol High homocysteine Smoking Stress Exercise Obesity Lowered
nutritional status Diabetes
2 High blood
pressure Age Male gender Family history Many times there are no symptoms, as sometimes blood vessel blockage is usually around 90% before symptoms start to appear. Often, the first sign is a heart attack or abnormal results on blood tests. Some people may experience chest pain known as Angina pectoralis in association with atherosclerosis. This type of pain may be a vague, heavy sensation resembling an ache or it may be a severe, intense stabbing or crushing sensation. Angina pain can travel in the shoulder, towards the arm and fingers, or even be felt in the abdomen. But not all cases of Angina are from atherosclerosis, although other causes are less common. In many individuals
with atherosclerotic heart disease there is a particular earlobe
crease. It is a diagonal crease appearing at a 45° downward
angle toward the shoulder. It is thought to happen from the lack
of blood flow to the skin of the ear and loss of elastin, a material
that keeps the ear flexible. It does not apply to Asian, Native
Americans or people with the rare condition known as Beckwith’s
syndrome. Diagnosis and Pharmaceutical Interventions Diagnosis of atherosclerosis can be made via invasive procedures such as angiography or angiogram, which can detect the narrowing of vessels but not the extent of the underlying disease as sometimes plaques are present in areas where there is still adequate blood flow. Occasionally non-invasive procedure such as Doppler ultrasonography will be performed. If the blood vessels to the heart are suspected to be involved a stress test maybe required. This test is performed with exercise, and assesses blood flow specifically to the heart muscle itself. Most diagnosis is made based on an assessment of a person’s risk factors and may include family history. Included in the assessment may be laboratory blood tests of fasting cholesterol, LDL, HDL and triglyceride levels, homocysteine and C-reactive protein. The standard definition of high cholesterol is having an excess of cholesterol in the blood, usually more than 200 mg/dl (5mmol/L), although many doctors are now citing 180 mg/dl as the maximum. The levels of LDL by itself is important, as well as the ‘good’ cholesterol HDL. When both these are taken they ratio is evaluated. For the LDL/HDL ratio, the lower the number is the better, most doctors recommend a value of 3 or less. Levels of plasma homocysteine should be 6.1- 17.0 micrograms per litre. Abnormal concentrations are classified as moderate (16-30), intermediate (31-100), and severe (greater than 100 µmol/L). Levels above 9 or 10 µmol/l warrant treatment. Often during cardiovascular disease situations there will be inflammation as a result, so the global inflammatory marker C-reactive protein (CRP) will be elevated. It is also used a predictive test for the first cardiovascular events among men, women, the elderly, those with metabolic syndrome or diabetes, and smokers. Normal values of C-reactive protein is 1-3 grams per liter, if is higher than 10 grams per liter than a serious inflammatory process is happening and should be found. In some incidences if the CRP is that high somebody may be having a heart attack. Pharmaceutical
interventions Antiplatelet drugs are geared toward keeping the blood viscosity low so that blood can flow smoothly through the vessels, reducing deposits in plaques, and keeping blood pressure normal, even when plaques are already present. Aspirin is the most common antiplatelet medication, which creates a blood thinning effect and increased bleeding times. People with a history of ulcers should not take aspirin due to the risk of internal bleeding. Aspirin has been shown to be damaging to the kidneys when habitually used. Surgical interventions are considered to be effective at reducing the size of plaques. Angioplasty is a technique where the occluded vessel is enlarged by a balloon tipped tube at the site of a plaque. Vessels can be dilated, or some times stent is left in place. Angioplasty is done for vessels of the heart, neck (for the blood to the brain) and abdomen. Coronary artery
bypass surgery (CABS) is the most common major cardiovascular operation
performed. This is a very invasive surgical procedure where the
vessels of the heart get rearranged and the plaques occluded vessels
gets bypassed. This procedure carries some risk, as the disease
may progress despite the surgery and there is also risk of brain
deterioration and stroke. Lifestyle and Dietary Modifications As with most conditions diet is the first and best place to start treatments. Dietary changes have been studied extensively, especially a low- fat, high fibre diet. These diets are low in saturated fat and low in trans-fatty acids (partially hydrogenated fats found in margarine and many processed foods containing vegetable oils), and higher in omega 3 fatty acids like those found in fish. It is also low in simple sugars/carbohydrate but high in complex carbohydrates and emphasizes lots of fruits and vegetables. Fruits and vegetable contain higher amounts of antioxidants and bioflavonoids, compounds important for health and the scavenging of free radicals that contribute to the oxidation in the plaque formation. Regular physical excise is important to reduce the risk of heart disease and stroke. By increasing blood flow and oxygen to the heart and tissues, it reduces blood pressure, reduces the chance of obesity and helps with a stressful lifestyle. Quitting smoking
is one thing you can do for your health that will help not only
reduce your risk of heart disease but improve overall health. Smokers
have lower levels of HDL, the ‘good’ cholesterol. Smoking
is the number one risk factor associated with several chronic diseases,
in including several forms of cancer, osteoporosis, and chronic
obstructive pulmonary diseases. Nutritional Factors shown to be Beneficial Tocotrienols/Vitamin
E Fish
Oil CoQ10
Terminalia
arjuna Garlic (allium
sativa) B
Vitamins Homocysteine reducing agents Recommended NaturalMeds Products for Atherosclerosis Vitamin
E Mixed tocopherols CoQ10
30 mg Ultimate
Omega EPA |
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