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atherosclerosis Alternative Names arteriosclerosis, hardening of the arteries Definition Atherosclerosis refers to fatty deposits formed under the inner lining of the blood vessels. The walls of the vessels become thick and less elastic. The thickened areas are called plaque. What is going on in the body? Atherosclerosis occurs when fatty substances, cholesterol, cellular waste products, calcium, and other materials build up on the inside lining of the arteries. The buildup is more likely to be in parts of the artery that have been injured. It usually occurs where the artery bends or branches. Once plaque builds up, it may cause the cells in the artery lining to make chemicals that cause more plaque buildup. Two problems can result from the plaque. First, the blood vessel can become narrow, preventing blood flow to the area served by the artery. For example, if an artery to the heart becomes 80% to 90% blocked, a person can develop chest pain. Second, the plaque can rupture and send a blood clot streaming through the artery. A blood clot that goes to other parts of the body is called an embolus. The embolus can be deposited in a smaller area of the artery or in another artery, completely cutting off the blood supply. This blockage can cause a heart attack, stroke, pulmonary embolus, or other serious medical problem. What are the signs and symptoms of the disease? The symptoms of atherosclerosis depend on which arteries are most affected by the buildup of plaque. Atherosclerosis can affect the heart, the kidneys, and virtually any other organ. Atherosclerosis of the arteries in the heart is called coronary artery disease. It can cause chest pain and heart attack. Atherosclerosis of the blood vessels leading to the brain can cause a stroke. Atherosclerosis of the blood vessels in the legs can result in leg pain during or after exercise. This is called intermittent claudication. Atherosclerosis of the blood vessels that supply the kidneys can cause kidney failure. What are the causes and risks of the disease? There are several factors that increase a person's risk of developing atherosclerosis, such as: cigarette smoking and secondhand smoke diabetes high blood cholesterol, especially a high level of LDL, the bad carrier for cholesterol high blood pressure high levels of triglycerides in the blood increased age lack of exercise male gender obesity What can be done to prevent the disease? In some cases, atherosclerosis cannot be prevented. A person may be able to reduce his or her risk for developing atherosclerosis in the following ways: Control diabetes. Eat a heart-healthy diet. Follow the American Heart Association, or AHA, recommendations for high cholesterol. Get 30 minutes of physical activity every day or almost every day. Maintain a healthy body weight. Seek effective treatment for high blood pressure How is the disease diagnosed? Diagnosis of atherosclerosis begins with a medical history and physical exam. A variety of special tests can be used to check the width of the openings in the arteries that supply the affected areas. What are the long-term effects of the disease? Unchecked atherosclerosis will continue to narrow the large and medium arteries supplying the body's vital organs. This can result in serious medical problems, such as heart attack, kidney failure, and stroke. What are the risks to others? Atherosclerosis is not contagious. It does, however, seem to run in families. If one or both parents have atherosclerosis, a person should make every effort to reduce his or her coronary risk factors. This is especially true for people whose parents developed atherosclerosis early in life. What are the treatments for the disease? Treatment of atherosclerosis focuses on lowering a person's coronary risk factors. Lowering blood cholesterol, controlling high blood pressure, and stopping smoking can stabilize plaque. However, these steps may not reverse the process. A low dose of aspirin taken on a regular basis seems to reduce the development of atherosclerosis and plaque. Atherosclerosis that progresses far enough to cause symptoms may require surgery. Surgery can remove or bypass plaque in the arteries that supply the brain, heart, kidneys, or legs. Angioplasty is a procedure in which a small balloon is inserted into an area of plaque. Then the balloon is inflated. When the balloon is deflated and removed, the opening within the artery is larger. This improves the blood supply. What are the side effects of the treatments? Medicines used to treat medical conditions may cause allergic reactions. Surgery carries a risk of bleeding, infection, and allergic reaction to anesthesia. What happens after treatment for the disease? Most people who have atherosclerosis are encouraged to begin a regular exercise program. A person who has atherosclerosis should make every effort to reduce coronary risk factors. This may include smoking cessation, control of chronic diseases and conditions, and a diet for preventing heart disease. Medicines may need to be adjusted to achieve the best response. How is the disease monitored? A person will have regular visits to the healthcare provider, along with tests to monitor the progress of the atherosclerosis. Any new or worsening symptoms should be reported to the healthcare provider.

Author: William M. Boggs, MD Date Written: 01/19/00 Reviewer: Eileen McLaughlin, RN, BSN Date Reviewed: 08/07/01 Potential conflict of interest information for reviewers available on request