Atherosclerosis

Atherosclerosis is one of the most serious health conditions affecting the Western World. It is responsible for the vast majority of heart disease and strokes, and is therefore the leading cause of death in the United States. This “silent killer,” as it is often called, is so prevalent in our society, and yet it is one of the most preventable illnesses we know of. Our out of balance lifestyles are largely the culprits behind most of the atherosclerosis we are forced to deal with. What can we learn and how can we change to defeat the onslaught of this menace? Let’s take a look…

What is Atherosclerosis?

Atherosclerosis (from the Greek athere, meaning gruel, and skleros meaning hard) is actually one of several forms of arteriosclerosis (arteria meaning artery). Arteriosclerosis is a general term for “hardening of the arteries.” Atherosclerosis affects the innermost lining of the artery, and is responsible for most coronary artery disease.

Atherosclerosis is a disease that causes the arteries to lose their elasticity and to be progressively narrowed so that they cannot function properly to carry blood and oxygen throughout the body. Deposits of plaque on the artery walls are responsible for narrowing them and impeding blood flow. Plaque is composed of cholesterol, calcium, fibrin (a fibrous material that aids in blood clotting), and waste products from the cells. The accumulation of plaque stimulates formation of substances which cause the inner layer of the artery walls (the endothelium) to thicken further, thus worsening the condition in a progressive manner.

Plaque can also break off or rupture causing a blood clot to suddenly form. This is a condition known as thrombosis, and can be very dangerous. A blood clot that blocks the flow of blood in the coronary arteries can cause a heart attack. If this happens in the carotid arteries and blocks blood flow to the brain, the result is a stroke. Blockage of the renal arteries can cause kidney failure. Any of these conditions can be fatal or seriously disabling.

Scientists still aren’t totally sure about how all the dynamics of atherosclerosis work together. Research indicates that once damage occurs to the artery walls from the formation and accumulation of plaque, a process occurs whereby the site of the damage encourages and attracts the growth of even more plaque. That is why this disease is so progressive. It is also why it is so important to reduce risk factors that cause the onset of atherosclerosis. We will discuss that in detail later in this article.

What Causes Atherosclerosis?

Atherosclerosis is a complex condition. Vast amounts of research have been done, but scientists are still not sure of the exact cause of atherosclerosis. However, there are some very well defined risk factors for the disease, some of which can be lessened, and some of which cannot.

The following risk factors can be controlled to a greater or lesser degree:

• Cigarette smoking. Never starting or quitting dramatically reduces a person’s chances of developing atherosclerosis or any coronary heart disease.
• Obesity. Being overweight puts a strain on the whole body, and specifically the heart and related organs of the circulatory system. Keeping a normal body weight will reduce your chances of getting atherosclerosis.
• Diabetes. Diabetics increase their risk of atherosclerosis or heart disease dramatically. Many diabetics actually die from atherosclerosis-related heart attacks. Researchers are currently focusing on better understanding this phenomenon.
• Hypertension. High blood pressure makes the heart work harder and damages the coronary arteries. Readings of 140 over 90 and greater are considered risky.
• High cholesterol. Cholesterol is a necessary substance manufactured in the liver. However, a diet high in animal fat and other insoluble fats can increase cholesterol blood levels to unhealthy levels. For many years, keeping cholesterol low was considered the holy grail of heart health. Just recently though, some research seems to indicate that the role of cholesterol has not been understood and interpreted correctly. Keep your ears open for more information. But don’t give up that low fat diet yet! Too much fat (of the wrong kind) is still not our friend.
• High triglycerides. Almost all fat in our food and in our bodies is in the form of triglycerides. A connection has been found between increased risk for atherosclerosis and other heart disease, and blood triglyceride levels of 400 mg/dL or greater.
• Lack of exercise, commonly known as “couch potato disease.” (wink)   Being inactive physically definitely increases one’s risk for all types of coronary disease.
• Now here’s some statistics that should be a wake up call for all of us. If I have two or more of these factors working against me, my risk for coronary disease or atherosclerosis increases exponentially. For example, if I have high cholesterol and hypertension, my risk increases by 300%.  But, if I also am a smoker, the risk jumps to an alarming 700%!  This also means I will probably die twenty to thirty years sooner. These are very scary numbers, but all of these factors can be controlled, minimized, or eliminated. The effect of my lifestyle and choices cannot be understated. It is huge!

There are also some risk factors that cannot be modified:

• Heredity. If your parents have a history of coronary disease, atherosclerosis, and/or strokes, you are at increased risk. A family history of hypertension also is risky. African-Americans as a whole generally have more hypertension than other folks, and this also puts them at more risk for coronary disease.
• Age. The risk of atherosclerosis naturally increases with age. Men are more at risk after age 45. Women after age 60.
• Speaking of men and women, gender is also a factor. Before age 60, a man is more likely to have a heart attack than a woman. The risk equalizes between the sexes at age 60. However, did you know that statistically a woman is much more likely to die from her first heart attack than a man is? Men might have more heart attacks, but be careful ladies! You can be in peril too.

Recently some other risks have been identified that, once considered secondary, may be at times more definitive than the so-called “primary” risk factors:

• Elevated levels of certain “silent inflammation markers” such as C-reactive protein and fibrinogen
• The Omega-3 Index. This measures levels of omega-3 fatty acids in the body. Some believe this to be the best and most accurate predictor of heart disease, even more effective than cholesterol readings or homocysteine levels.

What Treatments are Available for Atherosclerosis?

While no cure has been found for atherosclerosis, effective treatments are available. The first step is a correct diagnosis. There are several popular procedures:

• An electrocardiogram measures the heart’s electrical activity. In addition, your health provider may prescribe an exercise electrocardiogram (stress test) which reads the impulses of the heart under stress, usually while on a treadmill or stationary bike.
• An echocardiography uses ultrasound to get a picture of the heart valves and chambers. Coronary disease may show abnormal movement in the images produced.
• Radionuclide angiography involves the injection of radioactive material into the bloodstream. A stress test may be involved as well. Pictures are then taken of the coronary arteries and heart chambers, and the blood flow is analyzed. Personally, I would get a second opinion before putting radioactive material into my body.
• Coronary angiography is considered the most accurate assessment tool, and it is also the only invasive one. A catheter equipped with a camera is inserted into an artery, and is guided into the heart. Motion pictures are taken with the help of a contrasting dye. If accumulations of plaque and blockages are present, they can be easily viewed.

Once diagnosis of atherosclerosis has been confirmed, there are many treatment options that can be explored. Mainstream medicine focuses on surgery and drugs, to no surprise. Surgical options include:

• Percutaneous transluminal coronary angioplasty, while technically considered to be non-surgical, is an invasive procedure. A balloon is inserted into the artery at the point of narrowing to widen the vessel. Its success rate is about 90%, but unfortunately 33% of patients experience narrowing of the artery again within 6 months.
• Coronary artery bypass surgery involves building a detour around blockages using a healthy vein or artery to supply blood and oxygen to the heart. Approximately 70% of patients experience total relief, while 20% receive partial relief.
• Three other procedures are considered semi-experimental:
  • Atherectomy: a surgeon shaves down the plaque deposits causing blockages
  • Laser angioplasty: a laser is inserted on a catheter and used to burn away plaque
  • A stent, or metal coil, is installed permanently to support the artery and keep it open
  • Chelation therapy, still considered controversial by many, uses anticoagulant drugs and nutritional substances to dissolve and wash out plaque into the kidneys and out of the body

Most of the common drugs prescribed are for the purpose of reducing blood cholesterol levels. One category of these drugs, called “statins,” has come under much controversy as of late. Many health providers are reconsidering their use. The side-effects are considerable, and some research even indicates that prolonged use may even increase dangerous cholesterol levels. The good news is, there are many alternatives to both drugs and/or invasive procedures.

What Natural Remedies are Available?

• Omega-3 fatty acids are extremely important atherosclerosis fighters. Cold-water fish such as salmon or cod are high in these essential fatty-acids. Studies have shown that subjects who consumed sufficient omega-3’s have about a 47% less chance of heart attacks or strokes than those who consumed no omega-3’s. For those of you concerned about the dangers of getting too much mercury from eating fish, a good omega-3 supplement might be a wise choice.
• Many herbs and natural extracts have been found to be helpful:
  • Grape seed or pine bark extract are loaded with flavonoids that do an excellent job of fighting free radicals due to their antioxidant properties. They also discourage inflammation
  • Garlic, gingko biloba, Siberian ginseng, and ginger all have properties that fight antioxidants, plaque, and/or reduce inflammation of the arteries and related organs. Myrrh, alfalfa, and turmeric are especially revered for their abilities to reduce cholesterol and triglyceride levels

How Important is Diet and Lifestyle to Treatment and Prevention?

Diet and lifestyle management are huge factors in fighting atherosclerosis.

• Eat a diet that is low in saturated fats, especially animal fats, sugar, and sodium.
• Drink lots of clean, fresh water. This helps to keep all your body systems working optimally, but is especially good for your heart and circulatory system.
• Consume lots of fruits and vegetables. The darker they are, the higher their levels of antioxidants (cartenoids). The fiber found in this produce is helpful as well.
• Garlic and onions are great tools too. They boost the immune system and are also high in antioxidants.
• Exercise is one of the best deterrents to all kinds of heart disease. Get off the couch, pick your favorite cardiovascular activity, and do it 3-4 times per week for at least 30 minutes. You’ll feel better and your heart will thank you!