Atherosclerosis: Causes, Symptoms, and Treatment

Atherosclerosis is a disease that occurs when plaques consisting of cholesterol, fat, and other substances accumulate on the inner surface of your arteries. Over time, these plaques narrow and harden your vessels, which blocks blood flow. This condition, known among the public as “arterial hardening,” is the fundamental cause of many serious cardiovascular diseases such as heart attack, stroke, and peripheral artery disease. Atherosclerosis is a disease that can progress silently but can be prevented and managed with proper lifestyle changes.

Atherosclerosis usually does not cause symptoms in the early stages. However, as your vessels begin to narrow, symptoms such as chest pain, shortness of breath, or leg pain may appear. In this article, we will comprehensively discuss what atherosclerosis is, its causes, symptoms, diagnosis and treatment methods.

What is Atherosclerosis?

Atherosclerosis is the formation of accumulations called “plaque” consisting of fat, cholesterol, calcium, and other substances on the inner walls of arteries in your body. Over time, these plaques grow, narrowing your vessel and causing it to lose its elasticity. Cracks formed on the plaques can lead to clot formation, suddenly stopping blood flow. As the disease progresses, it can lead to serious problems such as heart attack and stroke.

What Causes Atherosclerosis?

Atherosclerosis is usually a process that begins in childhood and progresses slowly over years. Although its exact cause is not fully known, it is thought to be the result of a damage process occurring in the vessel wall. The main factors causing this damage include high blood pressure, high cholesterol, smoking, diabetes, and obesity. These factors irritate the inner surface of your vessel walls, preparing the ground for plaque formation. Genetic predisposition and unhealthy eating habits are also important factors that increase atherosclerosis risk.

The most important risk factors leading to atherosclerosis are:

• High Cholesterol: High levels of “bad cholesterol” (LDL) in the blood play a key role in plaque formation.
• High Blood Pressure (Hypertension): High blood pressure creates constant tension on vessel walls and damages the inner surface of vessels.
• Smoking: The chemicals in cigarettes directly damage vessel walls and accelerate plaque formation.
• Diabetes: High blood sugar levels cause damage to vessel walls and accelerate atherosclerosis development.
• Obesity: Excess weight increases atherosclerosis risk by triggering other risk factors such as high blood pressure and diabetes.
• Sedentary Lifestyle: Lack of physical activity causes cholesterol and blood pressure levels to rise.
• Age: As age advances, vessels naturally harden and atherosclerosis risk increases.
• Family History: People with a family history of early heart disease or atherosclerosis have higher risk.

What are the Symptoms of Atherosclerosis?

Atherosclerosis usually progresses silently for many years and does not cause obvious symptoms. However, when vessel narrowing reaches critical levels or a clot forms, symptoms appear. Symptoms vary according to the location of the affected vessel. For example, when vessels feeding the heart narrow, you may feel chest pain; when vessels feeding the brain narrow, you may experience stroke symptoms; when vessels feeding the legs narrow, you may feel pain or cramps while walking.

The symptoms that appear according to the organs affected by atherosclerosis are:

In Heart Vessels (Coronary Artery Disease):

• Chest Pain (Angina Pectoris): Pressure, squeezing, or pain felt in the chest during exercise or stress.
• Shortness of Breath: Shortness of breath felt when adequate blood does not reach your heart.
• Heart Attack: Sudden and severe chest pain as a result of plaque rupture and vessel blockage with clot.

In Brain Vessels (Carotid Artery Disease):

• Transient Ischemic Attack (TIA): Sudden numbness or weakness in face, arm, or leg, speech difficulty, or vision loss.
• Stroke: Permanent damage that occurs as a result of interrupted blood flow to the brain.

In Leg Vessels (Peripheral Artery Disease – PAD):

• Intermittent Claudication: Pain or cramps in legs and calves while walking, pain that passes with rest.
• Coldness or Numbness in Feet: Due to inadequate blood reaching legs and feet.

In Kidney Vessels:

• High Blood Pressure: Narrowing of kidney vessels can raise blood pressure.

Who Gets Atherosclerosis?

Atherosclerosis can be seen in almost everyone who has risk factors. Especially individuals with high blood pressure, diabetes, and high cholesterol are at the highest risk for the development of this disease. Smokers, those with obesity problems, and those with a sedentary lifestyle are also among the groups where atherosclerosis is most commonly seen. Genetic predisposition increases the likelihood of the disease appearing at early ages.

How is Atherosclerosis Diagnosed?

Atherosclerosis diagnosis begins with the evaluation of your risk factors. Your doctor measures your blood pressure, cholesterol level, and blood sugar. The main methods used for diagnosis include ECG, stress test, echocardiography, ultrasound, and angiography. These tests help us evaluate the condition of your vessels, blood flow, and heart function.

The main methods used in atherosclerosis diagnosis are:

• Blood Tests: Cholesterol levels (LDL, HDL, triglyceride), blood sugar levels, and inflammatory markers are evaluated.
• Electrocardiogram (ECG): Measures your heart’s electrical activity and helps detect signs of heart attack or rhythm disorders.
• Stress Test: Performed to see how well your heart works during exercise. Narrowings in your heart vessels can cause changes in ECG during exertion.
• Echocardiography: A heart ultrasound that evaluates your heart muscle movement and pumping function.
• Doppler Ultrasound: Shows blood flow and possible narrowings especially in your carotid (neck) or leg vessels.
• Angiography: Contrast agent is injected into your vessels and X-rays are taken, clearly showing vessel blockages or narrowings. This is the gold standard method for diagnosis.

How is Atherosclerosis Treated?

Atherosclerosis treatment includes a combination of lifestyle changes, medications, and in some cases surgical or interventional methods. The main goal of treatment is to slow the progression of the disease, stop plaque growth, and reduce the risk of clot formation. Lifestyle changes (healthy nutrition, exercise) are the most fundamental and important part of treatment.

The methods applied in atherosclerosis treatment are:

Lifestyle Changes:

• Healthy Nutrition: A diet low in saturated fat and cholesterol, rich in fruits, vegetables, and whole grains.
• Regular Exercise: Regular aerobic exercises such as walking, running, or swimming improve your blood circulation.
• Quitting Smoking: This is the most important step to stop disease progression.

Medication Treatment:

• Statins: Slow plaque growth by lowering cholesterol levels.
• Antihypertensives: Used to control high blood pressure.
• Blood Thinners: Used to prevent clot formation (such as aspirin, clopidogrel).

Interventional and Surgical Treatment:

• Angioplasty and Stent: Opening a narrowed vessel by inflating a balloon and placing a stent inside to keep it open.
• Bypass Surgery: Creating a new vessel pathway around the blocked vessel to restore blood flow.

What are the Complications of Atherosclerosis?

When atherosclerosis is not diagnosed and treated in time, it can lead to serious and permanent complications. The most dangerous complications occur as a result of plaque rupture and clot formation in the vessel. This condition can leave permanent damage to organs depending on the affected vessel and can be life-threatening. Disease progression can reduce your quality of life by disrupting the functions of your heart and other organs.

The main complications that atherosclerosis can cause are:

• Heart Attack: When a plaque in the coronary arteries feeding the heart ruptures and a blood clot completely blocks the vessel, part of the heart muscle may die.
• Stroke: When vessels feeding the brain are blocked, brain cells are deprived of oxygen and permanent damage occurs.
• Aneurysm: This is ballooning that occurs as a result of weakening of the vessel wall. If this aneurysm bursts, it can cause life-threatening internal bleeding.
• Peripheral Artery Disease (PAD): As a result of narrowing or blockage of leg and arm vessels, pain, numbness, and difficulties in wound healing are experienced in extremities. In severe cases, there is risk of gangrene and limb loss.
• Kidney Failure: Narrowing of vessels feeding the kidneys can lead to deterioration of kidney functions and eventually kidney failure.
• Heart Failure: This is the condition where the heart muscle weakens due to narrowing of coronary arteries and cannot pump adequate blood to the body.

What are the Ways to Prevent Atherosclerosis?

You can control risk factors by adopting healthy lifestyle habits. Healthy nutrition, regular exercise, quitting smoking, limiting alcohol consumption, and maintaining your ideal weight are the most important steps to take to prevent atherosclerosis. Regularly checking your blood pressure and cholesterol levels is also important.

What you can do to reduce atherosclerosis risk:

• Healthy Nutrition: Prefer nutrition models such as DASH or Mediterranean diet that are low in saturated fat and salt, rich in fruits, vegetables, and fiber.
• Regular Exercise: Do at least 150 minutes of moderate-intensity aerobic exercise per week.
• Stay Away from Cigarettes: Quitting smoking or never starting is the best thing you can do for your vascular health.
• Healthy Weight: Try to keep your body mass index (BMI) in the healthy range.
• Stress Management: Try methods such as meditation and yoga to manage your stress level.
• Controlled Blood Pressure and Cholesterol: Have your blood pressure and cholesterol levels measured regularly and do not neglect medication treatment if deemed necessary.

When Should You See a Doctor?

If you are experiencing atherosclerosis symptoms such as chest pain, shortness of breath, leg pain, or numbness, you should see a doctor without delay. Especially if chest pain starts suddenly and radiates to your left arm or jaw, it may be a sign of heart attack and you should immediately go to the nearest emergency room. Remember, early diagnosis and treatment are of vital importance to prevent serious complications caused by atherosclerosis.

Reference: Atherosclerosis