April 11, 2022 Author : Victor Gil Atherosclerosis is a vascular disease highly prevalent in the Portuguese population. It shares risk factors with several cardiovascular diseases and is itself a risk factor for these diseases, both acute and chronic, which globally represent the main cause of death in Portugal. Atherosclerosis can be present from a young age; In its mild forms it may not have symptoms; Its exact cause is unknown, it is probably multifactorial, There are cases with genetic predisposition or associated with genetic diseases, such as familial hypercholesterolemia; Atherosclerosis diagnosis as early as possible and control of cardiovascular risk factors is essential to avoid complications of the disease and to maintain a good quality of life. What happens in atherosclerosis Atherosclerosis is a slow and progressive inflammatory process , in which there is infiltration and accumulation of lipid particles (fat, including cholesterol) and cells (macrophages and lymphocytes) in the innermost layer of the arteries wall. It can affect any artery in any region of the body. Over time, the accumulation of particles forms atherosclerotic plaques , or atheroma, adherent to the inner surface of the artery wall; The gradual growth of atherosclerotic plaques makes them reduce the caliber of the affected arteries thus becoming obstacles to the normal blood flow ; Atherosclerotic plaques can shed fragments or trigger blood clots formation. Thus, a process with a slow evolution, which initially, even for years, may not cause any problems, or even not be known, is responsible for debilitating symptoms in more advanced stages and can be the cause of acute cardiovascular events associated with mortality or significant disability. Initially, the atherosclerosis symptoms may occur only in effort situations, like physical exertion; Symptoms progressively worsen due to ischemia (deficit in blood supply) in the areas irrigated by the affected arteries, causing, for example, angina pectoris, intermittent claudication of the lower limbs and vascular dementia; Circulation of atheromatous fragments (emboli) and blood clots (thrombus) can obstruct vessels and be the cause of acute cardiovascular events, like myocardial infarction, stroke, or acute limb ischemia, depending on which artery is obstructed and of the affected region. Controlling risk factors At the basis of atherosclerosis development are, in most cases, risk factors such as: High cholesterol; Arterial hypertension; Diabetes; Overweight and obesity; Tobacco consumption. These important risk factors for atherosclerosis are common to many other cardiovascular diseases, although their relative importance may differ. In addition to the aforementioned risk factors, there are others, that potentiate or facilitate atherosclerosis and cardiovascular diseases, for example: Age; Family history of premature cardiovascular disease; Poor living conditions; Emotional stress; Unhealthy lifestyle, with physical inactivity and inappropriate eating habits; Sleep disorders, in particular obstructive sleep apnea syndrome; Inflammation of unknown cause or associated with diseases such as rheumatoid arthritis, lupus, psoriasis or inflammatory bowel disease; Migraine; Preeclampsia or hypertension during pregnancy. Some factors associated with the development of atherosclerosis cannot be changed, such as age or family history. Many others are modifiable by adopting healthy lifestyles , including a healthy diet and regular physical exercise, and in appropriate cases, pharmacological therapy. Seek medical care Suspicion of atherosclerosis, a family history of disease, the presence of risk factors, or of comorbidities that increase the risk of atherosclerosis should motivate a medical consultation. Early diagnosis and treatment can prevent atherosclerosis worsening and prevent a heart attack, stroke, or other vascular medical emergencies. Read also: Atherosclerosis: symptoms and diagnosis Atherosclerosis: treatment and prevention Meet the cardiology clinical team from Hospital da Luz network and book your consultation The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
