Is Atherosclerosis Reversible?
Thought until recently to be irreversible, atherosclerosis lays down the foundation for ischemic heart disease and ischemic strokes. These are responsible for more deaths and disabilities than most other causes of death.
How Does Atherosclerosis Develop?
Atheromatous plaque in an artery (transverse section)
What happens is the walls of the artery become infiltrated with cholesterol and other fats that are present in the blood in excessive amounts due to unhealthy eating. In time, these deposits increase in size and trigger a local inflammatory response whose result is, among other things, fibrous tissue formation and calcium accumulation inside the developing plaque. Eventually the plaque hiders the blood flow through the artery, causing a turbulent flow.
Atheromatous plaques have a negative impact not only on the inside of the arteries, but also on the actual arterial walls that become rigid, or hard as pipes. The combined result of these factors is damaging to the delicate inner lining of the arteries (endothelium
), including endothelial ruptures at the surface of the plaques. In an attempt to repair the damage, specialized blood cells called platelets adhere to the ruptured site and often a blood clot forms there.
What in other circumstances is beneficial, in large, ruptured plaques can be devastating. The clot can block the blood flow through the vessel completely, causing the death of the tissues fed by it. If this happens to be a heart or a brain artery, the result is a heart attack or an ischemic stroke.
When Does Atherosclerosis Develop?
Despite the fact that its name indicates a disease of old age, atherosclerosis has a fairly early onset.
Early atherosclerosis in the aorta
(the largest artery that emerges from the heart)
see white arrow.
Autopsies on American soldiers who died in the Vietnam war revealed the presence of atheromatous plaques in many of the major arteries. Subsequently this process has been found even in 10-12 years old children who died in car accidents. With the increasing consumption of junk food and lack of exercise, it can be safel said that, in most people, atherosclerosis starts during childhood.
What Are the Consequences of Atherosclerosis?
Although atherosclerosis can develop in any artery, we don't feel anything until quite late in the process. You have to have a blockage (or stenosis
) of at least 75% of an artery before you start feeling it. This means that you could be feeling great, but if you are over 30-40 years old and you have risk factors for heart disease in your lifestyle, your arteries could have significant stenoses caused by atheromatous plaques.
Some of the consequences of atherosclerosis:
- Ischemic heart disease
- Acute myocardial infrction (or heart attack)
- Ischemic stroke
- Perpheral vascular disease
How Can I Detect Early Atherosclerosis?
Usual blood tests are not able to tell whether one has atherosclerosis or how advanced it is. There are several lifestyle factors that make its presence very likely: smoking, eating a lot of animal fats, sedentarism, high blood pressure. In addition, there are several specialized tests that can identify the presence and the severity of atherosclerosis.
One such test is the stress test, in which an ECG is performed during physical (or chemically induced) exertion. If there is significant stenosis of coronary arteries, the ECG tracing will reveal them.
An even better test is the coronary angiography (or the cardiac catheterization). The arteries feeding the heart are injected with a dye that makes possible the visualization of the inside of these arteries and their major branches, allowing the cardiologist to appreciate the presence as well as the severigy of atheromatous obstructions.
How Can I Prevent or Reverse Atherosclerosis?
As stated in the beginning, the good news is that atherosclerosis is reversible and can be prevented. Dr. Ornish found that patients who follow the health habits listed below experienced a reduction in the degree of stenosis of their coronary vessels.
- Smoking cessation
- Strict vegetarian diet (no meat, eggs, or other animal foods except for non-fat milk)
- Regula physical activity
- Adequate stress management
Author: Dr Gily.