Atherosclerosis

Arteriosclerosis Causes

Any damage or injury to the inner layer of the artery leads to the development of fatty plaques. This damage can be caused by,

1. High level of cholesterol
2. High blood pressure
3. Diabetes

What are the warning signs of arteriosclerosis?

No signs and symptoms appear until the arteries become narrow, thick, and stiff. The clinical presentation may be similar to other heart problems like,

• Chest pain
• Sudden numbness in your legs or arms
• Weakness
• Difficult or slurred speech
• Erectile dysfunction (rare)
• Difficult breathing
• Paralysis
• Extreme anxiety
• Loss of appetite
• Headache
• Hands and foot swelling
• Faintness
• Vomiting

Arteriosclerosis Treatment

No treatment is available that stops the formation of plaques in the arteries. However, lifestyle modifications help to avoid the worsening of arteriosclerosis. However, the doctor may prescribe certain medications to reduce the risk of other heart problems.

• Statins: Statins are given to reduce the level of cholesterol in your body. They are the most common medicines used for high cholesterol levels. They reduce the amount of cholesterol that your body makes.
• Diuretics: They are cheap and effective for the management of high blood pressure. They are more effective in older patients and resistant to hypertension. There are two main types of diuretics, loop, and thiazide. Drugs included are bendroflumethiazide, spironolactone, and furosemide.
• Calcium channel blockers: They are well tolerated, especially for elderly patients and those with ischemic heart disease or diabetes. They protect the heart tissue by inhibiting the entry of calcium into cardiac and smooth muscles. All calcium channel blockers are arteriolar vasodilators. They cause a decrease in soft muscle tone and peripheral vascular resistance. There are two main types of calcium channel blockers, dihydropyridines, and nondihydropyridines. Dihydropyridines include amlodipine, felodipine, and nifedipine. Nondihydropyridine calcium channel blockers include diltiazem and verapamil.
• Beta-blockers: They decrease the myocardium oxygen demand by blocking β1receptors. As a result, a decrease occurs in heart rate, contractility, cardiac output, and blood pressure. They can also reduce oxygen demand even during rest or exertion. Drugs included are atenolol, bisoprolol, metoprolol, pindolol, and propranolol.
• Angiotensin-converting enzyme (ACE) inhibitors: They are more effective in younger patients and those with diabetes or heart failure. Drugs include captopril, fosinopril, perindopril, lisinopril and ramipril.
• Angiotensin II receptor blockers: They antagonize the effects of angiotensin II directly at the AT1 receptor. They are practical and recommended for use in patients who cannot tolerate ACE inhibitors due to severe cough. Losartan, valsartan, candesartan and irbesartan are angiotensin II receptor blockers.
• Αlpha Blockers: They are used as second-line agents for the treatment of hypertension. They are more expensive and less effective than other drugs. Drugs included are terazosin, prazosin and doxazosin.
• Vasodilators: They are third-line agents for the management of blood pressure. They are poorly tolerated and are used in severe hypertension and gestational hypertension. There are two main types of vasodilators, central and direct acting. Direct-acting vasodilators are diazoxide, minoxidil, and nitroprusside. Centrally acting vasodilators are methyldopa and moxonidine.
• Antithrombotic agents: They reduce the formation of blood clots (thrombi). They can be used therapeutically for the prevention or treatment of thrombus. Two types of drugs are used aspirin and clopidogrel. Aspirin causes irreversible inactivation of cox-I hence thromboxane. Chewable aspirin provides more rapid blood levels. Patients who are allergic to aspirin must receive clopidogrel.
• Surgical procedures: The surgical treatment for arteriosclerosis includes:
• • Coronary angioplasty
  • Coronary artery bypass graft
  • Carotid endarterectomy

Factors that increase risk of arteriosclerosis:

The following factors increase the risk of arteriosclerosis,

1. Increasing Age
2. Gender
3.  Family history
4.  Smoking
5.  Hypertension
6.  Diabetes
7.  Stress
8.  A diet rich in fats 
9.  Genetic abnormalities
10.  Male gender
11.  Physical inactivity
12.  Chlamydia pneumoniae infection