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Atherosclerosis: A disheartening, preventable risk factor

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Omar P. Haqqani, MD
Midland Daily News
February 12, 2017

A number of risk factors can contribute to the development of vascular disease – all with different symptoms, levels of progression, and ways they can affect various parts of the vascular system. Atherosclerosis is among these risk factors.

Atherosclerosis is a condition that negatively affects blood flow, through means of unnatural hardening and contraction of the arteries.

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When the condition occurs, a thin layer of cells lining the arteries called the endothelium is affected. The endothelium helps the internal structure of the arteries toned and smooth – making it all the more harmful when atherosclerosis takes places, affecting this structure and negatively affecting blood flow.

If LDL, or the “bad” cholesterol, comes into contact with damaged endothelium, white blood cells swarm in order to properly digest the cholesterol. Over time, plaque develops from the mixture of cholesterol and cells in this area and forms in the artery.

When the blockage accumulates to a certain level, oxygenated, nutrient-rich blood is unable to properly flow through the arteries. However, plaque can grow in a variety of ways.

In some cases, plaque doesn’t block blood flow and stays in the wall of an artery, never causing symptoms. In other cases, plaque can slowly escalate to the point where it enters into the path of circulation.

However, when the accumulation of plaque grows to the point of rupture, blood clots can form inside the artery, which can cause a stroke in the brain or a heart attack.

Atherosclerosis is not only one of the most prominent causes for heart attack and stroke, but is also a main contributor to various types of vascular disease, including renal artery stenosis and mesenteric ischemia.

It’s important to understand not only the severity of atherosclerosis, but also its prominence in the human body. Those who are 40 and generally healthy, for example, have a 1 in 2 chance of developing a serious case of atherosclerosis in their lifetime.

Though the number of deaths as a result of atherosclerosis has fallen over the past 30 years, thanks to improved methods of treatment and lifestyle changes, atherosclerosis is still prominent and can have a devastating effect on the vascular system.

Mesenteric ischemia, either acute or chronic, occurs when the mesenteric vessels receive improper blood flow. Because atherosclerosis affects the lining of arterial walls, blockage can occur in these vessels, and can result in either ischemia or gangrene in the bowel wall.

Acute mesenteric ischemia occurs as a sudden medical emergency, while chronic mesenteric ischemia is a gradual process.

Renal artery stenosis can also be developed through atherosclerosis, as the condition can cause the hardening and narrowing of the renal arteries – the vascular connection between the aorta and kidneys.

Some risk factors for the development of atherosclerosis can come from prior conditions, such as high blood pressure, diabetes, and high cholesterol. However, in some cases, atherosclerosis can be controlled through preventable means.

First, if you currently smoke, then quit. Second, eat a diet rich in fruits, vegetables, whole grains, as well as exercise regularly, to help strengthen your cardiovascular system. Finally, it’s important to control the intake of alcohol when controlling the risk of developing atherosclerosis.

Treatment for atherosclerosis stems from the major goals of lowering the risk of blood clot formation, preventing disease, and reducing risk factors so the formation of plaque will stop.

Statin medication can be prescribed to help control or lower cholesterol levels, as well as lower blood pressure and blood sugar levels, and prevent blood clots and inflammation.

In severe cases of atherosclerosis, however, surgical intervention may be necessary. A coronary angioplasty to help open blocked or narrowed coronary arteries, or a bypass graft to help improve blood flow to the heart by means of going around the blockage, are two examples of these procedures.

By understanding and actively making an attempt to control risk factors for atherosclerosis, you’ll put yourself at a better chance of preventing the development of damage to the endothelium, allowing for blood to flow freely through the arteries.

Dr. Omar P. Haqqani is the chief of Vascular and Endovascular Surgery at Vascular Health Clinics in Midland.

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