By atherosclerosis the inside of the arteries are thickened, hardened and stiffened, causing the space for blood flow to be narrowed or closed. This will decrease the oxygen supply to local or distant tissues.

The primary symptom of this is pain, poor organ function and bad general condition. The further consequences are tissue damage, sometimes acute damage because by stop of blood flow caused by a sudden blood clot formed in the narrowed areas.

THE MECHANISMS AND CAUSES OF ATHEROSCLEROSIS

The inner walls of the arteries consist of an innermost layer of endothelial cells (surface cells) and under these a layer of smooth muscle cells. The changes by atherosclerosis take place under the endothelial cells and in this muscle layer. The changes consist of: A certain degree of cell proliferation or tumour, gathering of cholesterol and fat. Deposition of calcium salts. Deposition of blood elements like fibrin.

The deposits are called atherosclerotic plaque or atheroma. Atherosclerosis is one of several types of artery thickening and hardening. Generally thickening and hardening of arteries is called arteriosclerosis. Often atherosclerosis is also called arteriosclerosis.

The development of atherosclerosis probably begins by a damage in the endothelium. This damage causes cholesterol and fat to penetrate into the vessel walls and deposit there. This also induces cells to proliferate. Later also calcium salts are deposited.

Factors that cause endothelial damage and thus atherosclerosis are:

-High content of cholesterol in the blood.

-High content of blood fat and especially saturated fat.

-Inflammation in the blood vessels. A sign of such inflammation is the presence of a substance called c-reactive protein.

-High amount of oxidation agents in the blood.

-High blood pressure.

-High content of low density lipoprotein (LDL) in the blood serum, and low content of high density lipoprotein (HDL) in the blood. Lipoprotein is a combination of a protein molecule and fat or cholesterol. Lipoproteins carry cholesterol or fat from place to place.

-Diabetes.

-High age.

-Smoking.

-Men have a somewhat higher chance of getting this condition than women.

-High content of the amino acid homocystein in the blood serum.

Many of these factors are ultimately caused by a bad diet and lack of daily exercise.

THE SYMPTOMS AND CONSEQUENCES OF ATHEROSCLEROSIS

Since atherosclerosis can affect all body parts, the symptoms will vary. Symptoms from the affected body parts are:

-Decreased performance, easy to tire out.

-Pain by physical activity, so called anoxic pain.

-By severe impairment of blood flow, tissue damage or sores can occur.

When the heart is affected, the symptoms will be:

-General bad condition.

-Anoxic pain from the heart by physical activity called angina pectoris.

-Feeling of not getting enough air, or breathing problems.

Atherosclerosis can cause blood clots that close the blood flow. There are several ways this can occur:

-The atherosclerotic plaque can rupture, making a sore in the inner wall of the vessel. At such a sore blood can coagulate, making a blood clot.

-The atherosclerotic plaque itself can grow to close a blood vessel.

-Blood coagulated at an affected area can tear loose, float with the blood stream to another place and prop a blood vessel at the new place.

-A portion of the plaque itself can tear itself loose and clog another blood vessel.

When the heart is stricken by a blood clot, heart tissue is suddenly destroyed, a condition called heart infarction, causing sudden heart failure or death.

When a blood clot strikes the brain, brain tissue is destroyed or impaired, causing paralysis, decreased consciousness, coma or other sudden functional impairments.

THE PREVENTION AND TREATMENT OF ATHEROSCLEROSIS

Atherosclerosis can be prevented and to some extend be cured by these measures, of which most are lifestyle adjustments:

-Eating just a little or moderate amount of fat.

-Eating just a moderate amount of sugar.

-The fat eaten should be a blending of different types of unsaturated fat from sources like: Olive oil, rape oil, sunflower oil, soy oil, walnut oil and fish. Then you will get enough of mono-unsaturated fat, omega-3-unsaturated fat, and omega-6-poly-unsaturated fat, but not too much of any of them.

-Eating much fish and just a little red meat.

-Eating a good amount of fruit and vegetables each day.

-Supply of enough vitamins, minerals and anti-oxidants.

-Only consuming moderate amount of salt.

-Stop smoking.

-Getting high blood pressure treated if lifestyle measures do not bring blood pressure down.

-Daily exercise fitted for one's own condition.

-Eliminate stress in the daily life and at the job.

-Stressing sown and getting enough rest.

By high cholesterol levels that do not react properly to lifestyle measures, cholesterol lowering medication can be used, such as HMG-CoA reductase inhibitors.

By serious local narrowing of an artery, surgery to clean out or widen the artery is sometimes performed. Sometimes the artery is replaced by a graft taken from another body part or by an artificial vessel. When this is done in the heart, it is denoted as bypass surgery.

Alternative treatment to clean out the arteries is an option. There is for example a treatment consisting of using the substance EDTA to carry constituents of plaque away from the arteries. The molecules of this substance have the ability to grip around other molecules, for example cholesterol molecules, and carry them away. There is however a controversy about the effectiveness of this treatment, called chelating therapy.