Get to know the difference between Atherosclerosis and Arteriosclerosis
Arteriosclerosis occurs when the blood vessels that carry oxygen and nutrients from your heart to the rest of your body (arteries) become thick and stiff, sometimes restricting blood flow to your organs and tissues. Healthy arteries are flexible and elastic, but over time, the walls in your arteries can harden, a condition commonly called hardening of the arteries.
Atherosclerosis is a specific type of arteriosclerosis, but the terms are sometimes used interchangeably. Atherosclerosis refers to the buildup of fats, cholesterol and other substances in and on your artery walls (plaque), which can restrict blood flow.
The plaque can burst, triggering a blood clot. Although atherosclerosis is often considered a heart problem, it can affect arteries anywhere in your body. Atherosclerosis may be preventable and is treatable.
Signs and Symptoms
Atherosclerosis develops gradually. Mild atherosclerosis usually doesn’t have any symptoms.
You usually won’t have atherosclerosis symptoms until an artery is so narrowed or clogged that it can’t supply adequate blood to your organs and tissues. Sometimes a blood clot completely blocks blood flow, or even breaks apart and can trigger a heart attack or stroke.
Symptoms of moderate to severe atherosclerosis depend on which arteries are affected. For example:
- If you have atherosclerosis in your heart arteries, you may have symptoms, such as chest pain or pressure (angina).
- If you have atherosclerosis in the arteries leading to your brain, you may have signs and symptoms such as sudden numbness or weakness in your arms or legs, difficulty speaking or slurred speech, temporary loss of vision in one eye, or drooping muscles in your face. These signal a transient ischemic attack (TIA), which, if left untreated, may progress to a stroke.
- If you have atherosclerosis in the arteries in your arms and legs, you may have symptoms of peripheral artery disease, such as leg pain when walking (claudication).
- If you have atherosclerosis in the arteries leading to your kidneys, you develop high blood pressure or kidney failure.
Development of atherosclerosis
Atherosclerosis is a slow, progressive disease that may begin as early as childhood. Although the exact cause is unknown, atherosclerosis may start with damage or injury to the inner layer of an artery. The damage may be caused by:
- High blood pressure
- High cholesterol
- High triglycerides, a type of fat (lipid) in your blood
- Smoking and other sources of tobacco
- Insulin resistance, obesity or diabetes
- Inflammation from diseases, such as arthritis, lupus or infections, or inflammation of unknown cause
Once the inner wall of an artery is damaged, blood cells and other substances often clump at the injury site and build up in the inner lining of the artery.
Over time, fatty deposits (plaque) made of cholesterol and other cellular products also build up at the injury site and harden, narrowing your arteries. The organs and tissues connected to the blocked arteries then don’t receive enough blood to function properly.
Eventually, pieces of the fatty deposits may break off and enter your bloodstream.
In addition, the smooth lining of the plaque may rupture, spilling cholesterol and other substances into your bloodstream. This may cause a blood clot, which can block the blood flow to a specific part of your body, such as occurs when blocked blood flow to your heart causes a heart attack. A blood clot can also travel to other parts of your body, blocking flow to another organ.
Hardening of the arteries occurs over time. Besides aging, factors that increase the risk of atherosclerosis include:
- High blood pressure
- Increased level of blood cholesterol
- Smoking and other tobacco use
- A family history of early heart disease
- Lack of exercise
- An unhealthy diet
The complications of atherosclerosis depend on which arteries are blocked. For example:
- Coronary artery disease. When atherosclerosis narrows the arteries close to your heart, you may develop coronary artery disease, which can cause chest pain (angina), a heart attack or heart failure.
- Carotid artery disease. When atherosclerosis narrows the arteries close to your brain, you may develop carotid artery disease, which can cause a transient ischemic attack (TIA) or stroke.
- Peripheral artery disease. When atherosclerosis narrows the arteries in your arms or legs, you may develop circulation problems in your arms and legs called peripheral artery disease. This can make you less sensitive to heat and cold, increasing your risk of burns or frostbite. In rare cases, poor circulation in your arms or legs can cause tissue death (gangrene).
- Atherosclerosis can also cause aneurysms, a serious complication that can occur anywhere in your body. An aneurysm is a bulge in the wall of your artery.
- Chronic kidney disease. Atherosclerosis can cause the arteries leading to your kidneys to narrow, preventing oxygenated blood from reaching them. Over time, this can affect your kidney function, keeping waste from exiting your body.
Your doctor will start with a physical exam. They’ll listen to your arteries and check for weak or absent pulses.
You might need tests, including:
• Angiogram, in which your doctor puts dye into your arteries so they’ll be visible on an X-ray
• Ankle-brachial index, a test to compare blood pressures in your lower leg and arm.
• Blood tests to look for things that raise your risk of having atherosclerosis, like high cholesterol or blood sugar
• Chest X-ray to check for signs of heart failure
• CT scan or magnetic resonance angiography (MRA) to look for hardened or narrowed arteries
• EKG, a record of your heart’s electrical activity
• Stress test, in which you exercise while health care professionals watch your heart rate, blood pressure, and breathing
You might also need to see doctors who specialize in certain parts of your body, like cardiologists or vascular specialists.
Management of Atherosclerosis
- Cholesterol medications. Aggressively lowering your low-density lipoprotein (LDL) cholesterol, the “bad” cholesterol, can slow, stop or even reverse the buildup of fatty deposits in your arteries. Boosting your high-density lipoprotein (HDL) cholesterol, the “good” cholesterol, may help, too.
- Anti-platelet medications. Your doctor may prescribe anti-platelet medications, such as aspirin, to reduce the likelihood that platelets will clump in narrowed arteries, form a blood clot and cause further blockage.
- Beta blocker medications. These medications are commonly used for coronary artery disease. They lower your heart rate and blood pressure, reducing the demand on your heart and often relieve symptoms of chest pain. Beta blockers reduce the risk of heart attacks and some heart rhythm problems.
- Angiotensin-converting enzyme (ACE) inhibitors. These medications may help slow the progression of atherosclerosis by lowering blood pressure and producing other beneficial effects on the heart arteries. ACE inhibitors can also reduce the risk of recurrent heart attacks.
- Calcium channel blockers.These medications lower blood pressure and are sometimes used to treat angina.
- Water pills (diuretics). Increased blood pressure is a major risk factor for atherosclerosis. Diuretics lower blood pressure.
- Other medications.Your doctor may suggest certain medications to control specific risk factors for atherosclerosis, such as diabetes. Sometimes specific medications to treat symptoms of atherosclerosis, such as leg pain during exercise, are prescribed.
Non Pharmacological Management
Lifestyle changes can help you prevent or slow the progression of atherosclerosis.
- Stop smoking. Smoking damages your arteries. If you smoke or use tobacco in any form, quitting is the best way to reduce the progression of atherosclerosis and reduce your risk of complications.
- Exercise most days of the week. Regular exercise can condition your muscles to use oxygen more efficiently.
Physical activity can also improve circulation and promote development of new blood vessels that form a natural bypass around obstructions (collateral vessels). Exercise helps lower blood pressure and reduces your risk of diabetes.
Aim to exercise at least 30 minutes most days of the week. If you can’t fit it all into one session, try breaking it up into 10-minute intervals.
You can take the stairs instead of the elevator, walk around the block during your lunch hour, or do some sit-ups or push-ups while watching television.
- Eat healthy foods. A heart-healthy diet based on fruits, vegetables and whole grains.
Try substituting whole-grain bread in place of white bread; grabbing an apple, a banana or carrot sticks as a snack; and reading nutrition labels as a guide to controlling the amount of salt and fat you eat. Use monounsaturated fats, such as olive oil, and reduce or eliminate sugar and sugar substitutes.
- Lose extra pounds and maintain a healthy weight. If you’re overweight, losing as few as 5 to 10 pounds (about 2.3 to 4.5 kilograms) can help reduce your risk of high blood pressure and high cholesterol, two of the major risk factors for developing atherosclerosis.
Losing weight helps reduce your risk of diabetes or control your condition if you already have diabetes.
- Manage stress. Reduce stress as much as possible. Practice healthy techniques for managing stress, such as muscle relaxation and deep breathing.
If you have high cholesterol, high blood pressure, diabetes or another chronic disease, work with your doctor to manage the condition and promote overall health.