AtherosclerosisRisk, Prevention and Treatment

Henry B. Sergio Jr

Atherosclerosis is degenerative. It isn’t acquired during adulthood.

Risk FactorsRisk factors (characteristics, symptoms, or

signs present in a disease-free person that are statistically associated with a greater chance of developing a disease) include smoking, high blood pressure, diabetes, high cholesterol levels, obesity, “type A” personality, sedentary lifestyle, and a family history.

Most of these can be modified by changing diet and other habits or can be controlled by taking medications. However, other risk factors are unmodifiable (beyond our control), including genetic predisposition (family history of disease at an early age), age, and gender.

For example, adult males are more likely than adult females to develop the disease; after age 70 the risks are roughly equal. Smoking is undoubtedly the number-one risk factor doubling the risk of morbidity and mortality.

Lipoproteins

-consist of an inner core of triglycerides and other lipids and an outer shell of proteins, phospholipids, and cholesterol.

Low-density lipoproteins (LDL)- transportcholesterol from the liver to body cells for use in cell membrane repair and the production of steroid hormones and bile salts.

High-density lipoproteins (HDL)- remove excess cholesterol from body cells and transport it to the liver for elimination.

How LDL contributes to atherosclerosis

Inflammation blood vessel dilates WBC’s (macrophage, phagocytes) + presence of excess LDL proteins & lipids oxidize in LDL’s secretion of substance by endothelial and smooth muscle cells monocytes macrophage foam cells + T cells intensify

inflammation =atherosclerosis

Diet and social interaction-food rich in fiber-healthy environment

Treatment Coronary artery bypass grafting (CABG)

-is a surgical procedure in which a blood vessel from another part of the body is attached (“grafted”) to a coronary artery to bypass an area of blockage. A piece of the grafted blood vessel is sutured between the aorta and the unblocked portion of the coronary artery.

Percutaneous transluminal coronary angioplasty (PTCA) -a balloon catheter is inserted into an artery of an arm or leg and gently guided into a coronary artery. Next, the catheter is advanced to the point of obstruction, and a balloonlike device is inflated with air to squash the plaque against the blood vessel wall.

Restenosis may be due to damage from the procedure itself, for PTCA may damage the arterial wall, leading to platelet activation, proliferation of smooth muscle fibers, and plaque formation.

A stent is a metallic, fine wire tube that is permanently placed in an artery to keep the artery patent (open), permitting blood to circulate