Atherosclerotic vascular disease -- commonly called atherosclerosis -- is a disease of the blood vessels in which plaque builds up in the lining of the artery walls. It can affect arteries anywhere in the body and carries a variety of health implications depending on the area affected and the extent of the atherosclerosis. Atherosclerosis is the underlying cause of most diseases of the heart and blood vessels -- collectively referred to as cardiovascular disease, which is the leading cause of death in the U.S. According to the Centers for Disease Control and Prevention, cardiovascular disease accounted for nearly 1 in every 3 deaths in 2010.
The Atherosclerotic Process
Atherosclerosis develops slowly and silently over a lifetime. It is fueled by inflammation that results from damage to the the artery wall. This damage may be caused by many agents, including smoking, high blood pressure, diabetes and elevated blood cholesterol and triglycerides. Cholesterol, fats, calcium and other materials collect at the site of the injury. With time, hard plaques develop and thicken, narrowing the artery and impeding blood flow. As atherosclerosis progresses, the plaques can rupture, causing blood clots to form at the site of the rupture. These clots contribute to further narrowing of the artery and may even totally block blood flow, resulting in tissue damage to the affected organ.
When atherosclerosis affects the arteries of the heart, it is called coronary heart disease. The buildup of plaque inside the coronary arteries limits the flow of blood to the heart muscle. A common symptom of coronary heart disease is chest pain or discomfort, especially with exertion. Coronary atherosclerosis may advance to the point that blood supply to an area of the heart becomes so limited, or even completely blocked, that muscle damage occurs in the form of a heart attack. The American Heart Association reports that 1 of every 6 deaths in 2010 was due to coronary heart disease and estimates that 620,000 Americans experience their first heart attack each year.
Atherosclerosis affecting the arteries that supply the brain can cause dementia, transient ischemic attacks and strokes. A transient ischemic attack -- or TIA -- is often referred to as a mini-stroke and can occur if blood supply is temporarily interrupted. A stroke occurs when the blood supply to the brain is blocked for a longer period and permanent damage results, often due to atherosclerosis or an associated clot. According to the American Heart Association, stroke was the fourth leading cause of death in 2010 and is also a leading cause of disability.
Peripheral Artery Disease
When atherosclerosis affects arteries supplying the legs, arms, kidneys or abdomen, it is called peripheral artery disease, or PAD. PAD affecting the legs is the most common. People with lower limb PAD may experience pain or numbness in the legs upon exertion, poor healing and skin changes and they often tend to become more sedentary as a result, precipitating a faster decline and greater loss of independence with aging. According to the American Heart Association, 8.5 million Americans age 40 and above are affected by PAD.
According to the American Heart Association and the American College of Cardiologists, lifestyle modifications can have a significant impact on the development and progression of atherosclerosis. Their recommendations for preventing or delaying atherosclerosis include abstaining from all tobacco products, eating a heart-healthy diet, exercising for at least 40 minutes 3 or 4 days per week and losing weight, if needed. Careful management of high blood pressure, elevated cholesterol and diabetes is important as well.
- Circulation: AHA Statistical Update Heart Disease and Stroke Statistics -- 2014 Update
- Centers for Disease Control and Prevention: Compressed Mortality Data
- Centers for Disease Control and Prevention: Morbidity and Mortality Weekly -- Prevalence of Stroke -- United States, 2006–2010
- Circulation: AHA Conference Proceedings -- Atherosclerotic Vascular Disease Conference
- Circulation: Inflammation and Atherosclerosis
- JAMA: Emerging Risk Factors for Atherosclerotic Vascular Disease -- A Critical Review of the Evidence
- Circulation: AHA/ACCF Guideline AHA/ACCF Secondary Prevention and Risk Reduction Therapy for Patients With Coronary and Other Atherosclerotic Vascular Disease -- 2011 Update
- Circulation: AHA Scientific Statement -- Secondary Prevention of Atherosclerotic Cardiovascular Disease in Older Adults
- Circulation: AHA Scientific Statement -- American Heart Association Guidelines for Primary Prevention of Atherosclerotic Cardiovascular Disease Beginning in Childhood
- Circulation: 2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk