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ATHEROSCLEROSIS

By Sanzhar Zhetkenev

Definition
The term atherosclerosis, comes from the Greek atheros (gruel or

paste) and sclerosis (hardness), defines the formation of fibrofatty


lesions in the intimal lining of the large and medium-size arteries such
as the aorta and its branches, the coronary arteries, and the large
vessels which are supply for the brain.

Risk Factors
The cause or causes of atherosclerosis have not been determined

with certainty.
Epidemiologic studies have identified predisposing risk factors:
Unchangeable risk factors
Age
Male gender
Men are at grater risk than are premenopausal women, because of the
protective effects of natural estrogens.

Family history of premature coronary heart disease


Several genetically determined alterations in lipoprotein and cholesterol
metabolism have been identified.

Causes
Lifestyle:
Hyperlipidemia

The presence of hyperlipidemia is the strongest cause for

atherosclerosis in persons younger than 45 years of age.


Both primary and secondary hyperlipidemia increase the risk.
Cigarette smoking
Hypertension
High blood pressure produces mechanical stress on the vessel
endothelium.
It is a major cause for atherosclerosis in all age groups and may
be as important or more important than hypercholesterolemia
after the age of 45 years.
Diabetes mellitus
Diabetes elevates blood lipid levels and otherwise increases the
risk of atherosclerosis.
Insufficient physical activity
A stressful lifestyle
Obesity

Pathology
The

lesions
associated
with
atherosclerosis are
of three types:
The fatty streak
The
fibrous
atheromatous
plaque
Complicated
lesion
The latter two are
responsible for the
clinically significant
manifestations of the
disease.

Response-to-injury hypothesis
1. Chronic endothelial injury
2. Accumulation of lipoproteins
3. Monocyte adhesion to the endothelium
4. Platelet adhesion
5. Factor release
6. SMC proliferations and ECM production.
7. Lipid accumulation

Symptoms
Atherosclerosis symptoms depend on which arteries are
affected. For example:
Atherosclerosis in heart arteries, have symptoms
similar to those of a heart attack, such as chest pain
(angina).
Atherosclerosis in the arteries leading to brain, have
symptoms such as sudden numbness or weakness in
your arms or legs, difficulty speaking or slurred speech, or
drooping muscles in your face.
Atherosclerosis in the arteries in arms and legs,
produces decreased blood flow is called peripheral artery
occlusive disease (PAOD).have symptoms such as leg
pain when walking
Sometimes atherosclerosis causes erectile dysfunction in
men.

Treatments and prevention


Thrombolytic therapy. If you have an artery that's blocked by a

blood clot, your doctor may insert a clot-dissolving drug into your
artery at the point of the clot to break it up.
Bypass surgery. Your doctor may create a graft bypass using a
vessel from another part of your body or a tube made of synthetic
fabric. This allows blood to flow around the blocked or narrowed
artery.
Lifestyle changes can help prevent or slow the progression of
atherosclerosis.
Stop smoking.
Exercise most days of the week.
Eat healthy foods
Manage stress
manage the condition of high cholesterol, high blood pressure,
diabetes or other chronic disease

References
http://www.nhlbi.nih.gov/health/health-

topics/topics/atherosclerosis
http://www.webmd.com/heart-disease/what-isatherosclerosis

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