home Folk remedies Atherosclerosis causes, symptoms, treatment and prevention. Atherosclerosis - what it is, types and causes of the disease, diagnosis, treatment. Why is atherosclerosis dangerous? Stages of development

Atherosclerosis causes, symptoms, treatment and prevention. Atherosclerosis - what it is, types and causes of the disease, diagnosis, treatment. Why is atherosclerosis dangerous? Stages of development

Good day, dear readers!

In this article we will look at such a disease of blood vessels as atherosclerosis, as well as its causes, symptoms, prevention and treatment of atherosclerosis, using traditional and folk remedies.

Atherosclerosis– a chronic disease of the arteries, the characteristic feature of which is the deposition of cholesterol and other fats on the inner walls of blood vessels. Subsequently, this “clogging” causes the walls of the vessels to thicken, the lumen to decrease, their elasticity to be lost, resulting in blockages of the vessels. Due to the deformation of blood vessels, there is a load on the heart, because it needs more effort to pump blood.

The result of atherosclerosis is diseases such as hypertension (hypertension), necrosis, etc.

According to statistics for 2000, in Russia 800 people die from cardiovascular diseases per 100,000 population! At the same time, in France there are 182 people, in Japan 187. Scientists have recognized that the reason for this situation is nutrition and lifestyle. Of course, in the current 2016, when the spread of GMO products has gained incredible momentum, and truly high-quality food products cost such an amount that most people cannot afford to buy them, mortality continues to rise.

In this regard, it has been established that middle-aged and elderly people are most often susceptible to atherosclerosis, although there have been cases where this disease was identified in children.

ICD

ICD-10: I70
ICD-9: 440

The development of atherosclerosis begins from the human circulatory system. In a healthy person, blood, circulating in the blood vessels, delivers oxygen and nutrients to all organs and tissues. With a normal diet, cholesterol is also present in the blood.

Cholesterol- an organic compound - a natural fatty (lipophilic) alcohol that is found in the cell membranes of the body. Cholesterol plays an important role in protecting cell membranes, and is also necessary for the production of steroid hormones (cortisol, estrogen, testosterone, etc.), bile acids, as well as the normal functioning of the immune and nervous systems.

Cholesterol is insoluble in water, and accordingly, it cannot independently enter the tissues of the body, therefore, the function of delivering it through the blood to all organs is performed by transporter proteins (apolipoproteins), which are found in complex compounds - cholesterol with other compounds.

Apolipoproteins are divided into 4 groups:

- high molecular weight (HDL, HDL (high density lipoprotein))
- low molecular weight (LDL, LDL, (low density lipoproteins))
- very low molecular weight (VLDL, VLDL, very low density lipoproteins);
- chylomicrons.

Depending on the “address” (body part) of delivery, different of these apolipoproteins perform the function. LDL, VLDL and chylomicrons combine with cholesterol and deliver it to peripheral tissues. But LDL (low-density lipoproteins) are poorly soluble and tend to precipitate. Due to this, cholesterol combined with LDL is called “bad” cholesterol.

Problems begin when an excess of cholesterol in the body, together with LDL, precipitates, which adheres to the walls of blood vessels and forms atherosclerotic plaques.

Here I would also like to note that low-density lipoproteins are counteracted by high-density lipoproteins (HDL), which protect the walls of blood vessels from their negative effects, but HDL, unfortunately, is 2 times less.

Atherosclerotic plaques– formations that consist of cholesterol, other fats, low-density lipoproteins and. They form under the endothelium (the inner surface of blood vessels), in places where it is damaged.

Under the endothelium (between the outer and inner walls of the vessel), i.e. in the thickness of the vessels, various substances are synthesized that regulate blood clotting, as well as the health of the vessels themselves.
So, as the atherosclerotic plaque grows, the lumen of the vessel narrows, and there is a risk of its rupture, from where a blood clot enters the vessel.

Thrombus- an accumulation of cells, mainly platelets and blood proteins. To put it simply, a thrombus is a clot of coagulated blood that occurs in places where blood vessels are damaged.

A thrombus aggravates the situation by the fact that it further narrows the lumen of the vessel, but the main danger from it is that a piece can come off from it, which, moving further along the vessels, reaches a place where the diameter of the lumen of the vessel is less than the thrombus. Further, in this place a blockage of the vessel occurs, and the tissues and organs “cut off” from the blood supply begin to die.

Of course, the process of development of atherosclerosis described above is a simplified form of explanation, but I hope that I was able to describe the overall picture.

Causes of atherosclerosis

At the moment, the causes of atherosclerosis continue to be studied. Let's highlight the most well-known reasons:

- endothelial dysfunction;
— damage to the endothelium by viruses (herpes virus, etc.);
- damage to the vascular wall by chlamydia, mainly Chlamydia pneumoniae;
- abnormalities in the functioning of leukocytes and macrophages;
- primary accumulation of a large number of lipoproteins in the thickness of the blood vessel;
— deviations in the functioning of the antioxidant system;
- an increase in the level of adrenocorticotropic and gonadotropic hormones with age, which leads to an imbalance of hormones necessary for regulating cholesterol.

Among the factors that provoke the development of atherosclerosis are:

— bad habits (drinking alcohol, smoking);
— hypertension (): blood pressure level from 140/90 mm Hg. Art.;
- hyperlipoproteinemia;
- sedentary lifestyle;
- unhealthy diet;
— ;
— ;
— ;
- heredity;
— ;
- homocysteinuria;
- hyperfibrinogenemia;
- postmenopause;
- age;
- metabolic disorders.

Symptoms of atherosclerosis largely depend on the location where it develops, as well as the vessel affected. Let's consider the most popular sites of injury and the accompanying signs of this disease.

Atherosclerosis of the heart

Coronary atherosclerosis. Occurs as a result of damage to the coronary vessels by atherosclerotic plaques. Based on this, the flow of oxygen and nutrients to the heart (myocardium) decreases.

Symptoms of coronary atherosclerosis:

Atherosclerosis of the aorta of the heart. It occurs as a result of damage to the main vessel of the heart, the aorta, by atherosclerotic plaques.

Symptoms of atherosclerosis of the aorta of the heart:

- burning periodic pain in the chest area;
- increase in systolic (upper);
- periodic dizziness;
- premature aging, graying;
- difficulty swallowing food;
- increased hair growth in the ears;
- appearance of wen on the face.

Atherosclerosis of the abdominal region

Atherosclerosis of the abdominal region (cardiac aorta). Occurs as a result of damage to atherosclerotic plaques of the aorta in the abdominal area.

Symptoms of atherosclerosis of the abdominal aorta

Symptoms of cerebral atherosclerosis

Complications of atherosclerosis

Conditionally acceptable food products (minimum quantity): vegetable oil (30-40 g/day), beef and lamb (no more than 90-150 g), eggs (no more than 2 pieces per week), whole milk, white bread, pasta.

What not to eat if you have atherosclerosis: butter, hard margarine, animal fat, caviar, egg yolks, brains, kidneys, liver, heart, tongue, meat with visible fat, sausages, ham, sausages, duck, goose, sour cream, full-fat milk, cream, full-fat cottage cheese, fatty varieties of cheese, curd cheeses, processed cheeses, ice cream, vegetables (cooked in fat), fruits (candied, sweetened), chocolate, candies, marmalade, marshmallows, jam and preserves.

For the treatment of atherosclerosis, M.I. Pevzner developed a special dietary food -.

In addition, it is necessary to minimize the use of:

- saturated fatty acids;
— ;
- - no more than 8 g per day.

Medicines for atherosclerosis

Medicines for atherosclerosis are used for:

— correction of blood pressure levels;
— control of diabetes mellitus;
— correction of metabolic syndrome;
— normalization of the lipid spectrum.

Depending on the above goals, they are divided into 4 main groups:

1. Drugs that block the absorption of cholesterol by the walls of blood vessels and organs.
2. Drugs that reduce the synthesis of cholesterol and triglycerides in the liver, as well as their concentration in the blood.
3. Drugs that increase the breakdown and excretion of atherogenic lipids and lipoproteins from the body.
4. Additional drugs.

Group 1: drugs that block the absorption of cholesterol by the walls of blood vessels and organs

IA - anion exchange resins: Gemfibrozil, Cholestyramine. This group of drugs absorb cholesterol and are then removed from the body along with it. The disadvantage is that vitamins and other medications are absorbed along with cholesterol.

IB – plant sorbents:"Guarem", "β-sitosterol". This group of drugs interferes with the absorption of cholesterol by the intestine.

Group 1 drugs can cause dyspepsia.

Group 2: drugs that block the absorption of cholesterol by the walls of blood vessels and organs

IIA (statins): lovastatin (Apexstatin, Mevacor, Medostatin), simvastatin (Vasilip, Zocor, Simvor), fluvastatin (Leskol), pravastatin (Lipostat, Pravachol), atorvastatin (Liprimar ", "Torvacard"), rosuvastatin ("Crestor"). Contraindications: should not be taken by pregnant women, nursing mothers, children, those with liver disease, or in combination with alcohol. Side effects: alopecia, myopathy, dyspepsia, rhabdomyolysis, impotence, hepatotoxicity.

IIB (fibrates): fenofibrate (Traykor), bezafibrate (Bezalip), ciprofibrate (Lipanor). Side effects: dyspepsia, myositis. Fenofibrates are the newest drugs, therefore, in the treatment of atherosclerosis, they are preferred. Fenofibrates are also used in the treatment of type 2 diabetes.

IIC: nicotinic acid (“Enduracin”). Side effects: skin itching, dyspepsia. Not recommended for use with diabetes.

IID: probucol (“Fenbutol”). Reduce sterol synthesis.

Group 3: drugs that increase the breakdown and excretion of atherogenic lipids and lipoproteins from the body

Unsaturated fatty acids: Linetol, Lipostabil, Omacor, Polyspamine, Thiogamma, Tribuspamin. Side effects: increased effect of antihyperglycemic drugs.

Group 4: additional drugs

Endotheliotropic drugs (nourish the endothelium): pyricarbate (“Anginin”, “Parmidin”), synthetic analogues of prostacyclin (“Vasoprostan”, “Misoprostol”), E (tocopherol) and C (ascorbic acid).

Important! Before using folk remedies against atherosclerosis, be sure to consult your doctor!

Folk remedies against the initial stage of atherosclerosis

- Mix 1 part of burdock roots with 1 part of the mixture in equal proportions, and medicinal caps. 1 tbsp. pour 350 ml of boiling water over a spoonful of the mixture. Leave for 1 hour. Use equal parts throughout the day.

- mix ripe fruits, peppermint and strawberry leaves, and oat straw in equal proportions. 1 tbsp. Pour 400 ml of water into a spoonful of the mixture and boil a little. Cool, strain and take 100 ml before meals during the day.

- mix in equal proportions the root, wild strawberry (stem, leaves and root), lemon balm leaves and. Pour 6 g of the collection into 300 ml of boiling water. Leave for 1 hour. Drink in equal proportions throughout the day.

- mix 2 parts hawthorn (inflorescences), 1 part (inflorescences), 1 part coltsfoot, 1 part birch (leaves). Pour 2 teaspoons of the mixture into 400 ml of boiling water. Leave for 3 hours. Drink 100 ml in the morning, 100 ml at lunch and 200 ml in the evening.

All of the above remedies are used throughout the year. Every 2 months, doctors recommend changing the collection to another.

Important! The initial stage of atherosclerosis does not show symptoms, so only a doctor can determine it. But these drugs can be used as preventive measures against atherosclerotic plaques.

Folk remedies for normalizing lipid metabolism

The following remedies accelerate the breakdown and removal of fats from the body, and also prevent the deposition of “bad” cholesterol on the walls of blood vessels.

1. Mix the following medicinal plants in equal proportions:

2. 1 tbsp. Add 400 ml of water to a spoonful of the above well-dried mixtures and simmer for 10 minutes over low heat. Then set the dishes aside and let the product sit for about 1 hour.

The decoction should be taken cooled 3 times a day, 100-150 ml, 30 minutes after meals.

Other folk remedies for atherosclerosis

Honey. Mix equal parts lemon juice and vegetable oil. Take this mixture in the morning, on an empty stomach, once a day.

Potato. Drink juice from one potato every morning.

Garlic. Grate the head and zest. Pour the mixture with 500 ml of water and let it brew for 3 days in a place protected from light. Take 2 tbsp infusion. spoons every morning.

Dill. 1 tbsp. Pour 200 ml of boiling water over a spoonful of dill seeds. Take the product 4 times a day, 1 tbsp. spoon. The product is also effective against.

Melissa. Instead of tea, take a decoction throughout the day. The remedy helps to cope if atherosclerosis is accompanied by tinnitus.

Nettle. Nettle baths are very helpful for treating atherosclerosis of the lower extremities. To do this, fill the bathtub with fresh nettles and fill it with hot water. Let it brew for 30 minutes, then add cool water to it in the required amount and you can take a bath for 30 minutes every other day.

Prevention of atherosclerosis

To minimize the risk of developing atherosclerosis, you must adhere to the following recommendations:

- give up bad habits: smoking, ;
— lead an active lifestyle: move more, do exercises, play sports, ride a bike

Atherosclerosis is a fairly common chronic disease characterized by its own progression. Atherosclerosis, the symptoms of which appear against the background of damage to medium and large arteries due to the accumulation of cholesterol in them (which determines the cause of this disease), becomes the cause of circulatory disorders and a number of serious risks provoked by this disorder.

general description

With atherosclerosis, atherosclerotic plaques form on the walls of blood vessels (they are based on fatty deposits in combination with growing connective tissue). Because of these plaques, narrowing of blood vessels occurs and their subsequent deformation. These changes, in turn, lead to disruption of blood circulation, as well as damage to internal organs. Large arteries are mainly affected.

Let's take a closer look at the picture of this disease. First of all, we note that the occurrence and subsequent formation of atherosclerosis depends on the following factors:

the state in which the vascular walls are located;
relevance of the genetic hereditary factor;
disorders in fat (lipid) metabolism.

Cholesterol, originally noted, is a fat; it helps ensure a number of different functions in our body. In other words, it can be considered as a building material used in cell walls. In addition, cholesterol is a component of vitamins and hormones, which ensure adequate functioning of the body. Approximately 70% of the total amount of cholesterol is synthesized in the liver, while the remaining part enters the body through food.

Note that cholesterol in the body is not in a free state; it is included in specific complex compounds of fats and protein - lipoproteins. Lipoproteins, in turn, enable its transfer from the liver to tissues through the bloodstream. If cholesterol in the body is in excess, then from the tissues it is sent to the liver, and this is where the excess amount is utilized. Disruption of the functioning of this mechanism leads to the development of the disease we are considering, that is, atherosclerosis.

In the development of atherosclerosis, the main role is played by low-density lipoproteins, abbreviated as LDL. They ensure the transportation of cholesterol from the liver to the cells, and such transportation is subject to a strictly defined amount, otherwise exceeding the level determines a serious risk for the possible development of atherosclerosis against this background.

As for the reverse transport of cholesterol from tissues to the liver, it is ensured by high-density lipoproteins, which in abbreviated form defines them as HDL, a separate class of anti-atherogenic lipoproteins. They ensure cleansing of the surface layer of cells from excess cholesterol. The risk of developing atherosclerosis occurs when HDL cholesterol levels are low and LDL cholesterol levels are high.

Let us dwell on the age-related characteristics of atherosclerosis. Thus, it can be noted that the initial type of changes within the walls of arteries (their medium and large caliber) are noted already at a young age. Subsequently, they evolve, during which they transform into fibroadenomatous plaques, which, in turn, often develop after the age of 40 years. This atherosclerotic vascular lesion is relevant in approximately 17% of cases in patients under 20 years of age, in 60% in patients under 40 years of age, in 85% in patients aged 50 years and older.

In the future, the picture of the disease looks like this. The arterial wall undergoes penetration into its base by fibrin, cholesterol and a number of substances, due to the influence of which an atherosclerotic plaque is formed. Being in excess amounts, cholesterol, when exerted accordingly, causes the plaque to increase in size, which creates an obstacle to adequate blood flow through the vessels in the area of the formed narrowing. Against this background, blood flow decreases and inflammation develops. Blood clots also form; they can subsequently break off, thereby posing a significant danger to the vessels that are vital in our body. This is due to the possibility of their blockage, which, in turn, will deprive the organs of the blood supply they require.

Causes of atherosclerosis

The causes of atherosclerosis can be very different, they are also equated with risk factors for the development of atherosclerosis, which indicates that compliance with these factors increases the risk of possible development of atherosclerosis in patients. In general, such risk factors can be divided into two main groups depending on the nature of the patient’s exposure to them. Thus, the causes of the development of atherosclerosis can be modifiable and unmodifiable (modifiable and non-modifiable).

Unchangeable (non-modifiable) reasons as can be determined from their name, it is impossible to change with one or another measures of influence (including medical ones). The following can be identified as such factors:

Changeable (modifiable) reasons, in turn, are characterized by the fact that the patient can influence them. This may include lifestyle adjustments, treatment, etc. Let us highlight separately the options that are relevant for the disease in question:

Atherosclerosis: stages

As we have already highlighted, the pathological process relevant for atherosclerosis is concentrated within the walls of the arteries. This, in turn, leads to the gradual destruction of the affected wall. In accordance with the degree of damage and its characteristics, 3 stages of atherosclerosis are determined, successive in their manifestation, and we will consider them below.

Atherosclerosis: symptoms

The aorta (abdominal and thoracic sections), mesenteric, coronary and renal arteries, as well as arteries of the brain and lower extremities are predominantly affected by atherosclerosis.

As part of the development of the disease, its asymptomatic (or preclinical) period and the clinical period are distinguished. The asymptomatic period is accompanied by an increased level of beta lipoproteins in the blood or an increased level of cholesterol in it, while symptoms, as can be understood from the definition of this period, are absent.

As for the period of clinical manifestations, they are relevant when the arterial lumen is narrowed by 50% or more. This, in turn, determines the relevance of the three main stages of the period: the ischemic stage, the thromonecrotic stage and the fibrotic stage.

Ischemic stage characterized by the fact that it disrupts the blood supply to a certain organ. As an example, we can highlight the picture of the course of this stage, in which myocardial ischemia against the background of atherosclerosis of the coronary vessels manifests itself in the form of angina pectoris. Thrombonecrotic stage characterized by the addition of thrombosis of arteries that have undergone changes. Atherosclerosis of the coronary arteries in this case can, in its course, reach complications in the form of myocardial infarction. And finally fibrous stage, which is characterized by the proliferation of connective tissue that occurs in organs that are ineffectively supplied with blood. Again, when considering atherosclerosis of the coronary arteries at this stage, one can distinguish the transition to the development of such a pathology as atherosclerotic cardiosclerosis.

As for the specific manifestations of atherosclerosis, its symptoms are determined based on what type of arteries is affected. Below we will look at the main options for the course of this disease.

Atherosclerosis of the aorta: symptoms

Atherosclerosis of the aorta is the most common manifestation of atherosclerosis; accordingly, it is detected in most patients. Atherosclerosis can affect its various parts, on the basis of which, in turn, the symptoms of the disease and its prognosis are determined.

As you probably know, the aorta is the largest vessel in our body. It starts from the heart (left ventricle), then branches, thereby forming many small vessels that spread to the tissues and organs of our body. The aorta consists of two main sections, which are located in anatomically different areas. These sections are the abdominal and thoracic aorta.

The thoracic aorta in the aorta is the initial section; it provides blood supply to the upper part of our body, respectively, these are the organs of the chest itself, the neck, head and upper limbs. As for the abdominal aorta, it is the final section; blood supply through it is provided to the abdominal organs. In turn, its final section is divided into two main branches, which are the left and right iliac arteries, through which blood flows to the lower extremities and pelvic organs.

In atherosclerosis of the aorta, the lesion that is relevant for this disease covers either the entire aorta along its length, or its individual areas. Symptoms in this case are also determined depending on where exactly the pathological process is localized and how pronounced the changes that arose in the walls of the aorta under its influence became.

The most dangerous complication caused by aortic atherosclerosis is an aortic aneurysm. With an aortic aneurysm, a certain section of the artery expands, which is accompanied by thinning of the vessel wall and an increased risk of rupture of the artery, which, in turn, can lead to life-threatening bleeding.

Atherosclerosis of the thoracic aorta: symptoms

There are no symptoms for a long time. Often, atherosclerosis of this department develops along with such forms of the disease as atherosclerosis of the coronary arteries of the heart (i.e., coronary arteries), as well as atherosclerosis of cerebral vessels.

The manifestation of symptoms is observed mainly at the age of 60-70 years, which is explained by the significant damage to the aortic walls by this time. Patients complain of burning pain in the chest area, systolic blood pressure increases, swallowing becomes difficult, and dizziness is common.

Less specific manifestations of symptoms may include early aging, which is also combined with the early appearance of gray hair. At the same time, an abundance of hair growth is noted in the area of the ears, a characteristic light stripe appears along the outer edge of the iris, and wen appears on the skin of the face.

Atherosclerosis of the abdominal aorta: symptoms

This form of the disease is diagnosed in almost half of the cases of all possible variants of its manifestation. Similar to the previous form, for a long time it may not manifest itself at all.

Atherosclerosis of the area under consideration acts as the cause of the development in patients of such a pathology as abdominal ischemic disease. It, similar to IHD (coronary artery disease), is characterized by the fact that it leads to disruption of blood supply against the background of vascular damage by atherosclerosis, which is particularly important for those organs that these vessels nourish.

Symptoms accompanying damage to the abdominal aorta may manifest themselves in the following:

Stomach ache. Such pain occurs after eating, the nature of the manifestation is paroxysmal, aching. As a rule, they are not too intense and do not have a clear localization. Such pain disappears on its own after a few hours.
Digestive disorders. In particular, complaints of bloating, constipation and diarrhea (alternating conditions) and decreased appetite are relevant.
Weight loss. This symptom is progressive and is caused by a persistent form of indigestion.
Arterial hypertension (high blood pressure), renal failure. High blood pressure is caused by the blood supply to the kidneys being disrupted. As for kidney failure, it develops due to the fact that their normal tissues gradually begin to be replaced by connective tissues. This, in turn, determines their gradual necrosis against the background of insufficient blood supply.
Thrombosis of visceral arteries. This complication is deadly if there is atherosclerosis of the part of the aorta in question; moreover, it requires immediate specialized medical care. When the vessels that provide blood supply to the intestines become necrosis, the intestinal loops become necrosis, which leads to massive inflammation of organs concentrated in the abdominal cavity and peritoneum (which determines peritonitis). Symptoms of this condition include severe pain that does not disappear when taking antispasmodics and painkillers. In addition, the pain is soon accompanied by a sudden deterioration in general well-being.

Atherosclerosis of cerebral vessels: symptoms

This form of atherosclerosis is no less common; in this case, the intracranial and extracranial vessels supplying the brain are affected. The severity of symptoms is determined based on the degree of damage to these vessels. Due to atherosclerosis of the cerebral vessels, the activity of the nervous system is gradually inhibited, and mental disorders or stroke may develop.

The first manifestations of symptoms of this form of atherosclerosis are diagnosed at 60-65 years of age in patients, and their interpretation in most cases is reduced only to the manifestations of signs of aging of the body. Meanwhile, such a belief is only partly correct. Aging itself is an irreversible physiological process, while atherosclerosis acts as a specific type of disease, the course of which, until it reaches certain limits, determines the possibility of cure, as well as the implementation of certain preventive measures against it.

Now let's move on to the symptoms. The initial manifestations of this form of atherosclerosis are episodic attacks of “ischemic attack”, during which relatively stable neurological symptoms appear. This particularly includes sensitivity disorders, which can manifest themselves either in a decrease in sensitivity on one side of the body, or in complete loss. There are also movement disorders in the form of paresis (partial loss of muscle strength) and paralysis. In addition, hearing, vision and speech impairments may occur. The listed symptoms, meanwhile, appear within a short period of time, after which they disappear.

With a severe form of cerebral atherosclerosis, a stroke often develops, in which necrosis of a certain area of cerebral tissue occurs. This condition is characterized by a persistent manifestation of the symptoms we have already discussed (loss of sensitivity, paralysis, loss of speech); it is treatable to a small extent.

Other manifestations of the symptoms of atherosclerosis of this form include a disorder of higher nervous activity in one form or another (in particular, this concerns intellectual abilities and memory), changes in character (pictiness, capriciousness, etc.), sleep disturbances, and the development of depressive states.

Lack of adequate treatment can lead to dementia (senile dementia). It, in turn, is a severe and, unfortunately, irreversible manifestation of a decrease in the higher functions inherent in the brain.

Stroke is the greatest danger of this disease. This condition is essentially a condition similar to myocardial infarction, a condition in which tissue death occurs. This condition is accompanied by increased mortality, as well as frequent disability of patients.

It should be noted that in some cases, symptoms indicating atherosclerosis of the cerebral arteries can be quite difficult to differentiate, for example, from the symptoms manifested in hypertensive encephalopathy or from actual disorders of cerebral blood supply due to the development of degenerative spinal diseases (for example, osteochondrosis). In reality, it often happens that in elderly patients many of the diseases that could be confused with atherosclerosis are relevant, therefore the diagnosis of this disease determines the need for an integrated approach to this process.

Atherosclerosis of the vessels of the lower extremities: symptoms

Similar to the forms we discussed earlier, atherosclerosis of the lower extremities (atherosclerosis obliterans) does not manifest itself for a long time, and this lasts until blood circulation through the vessels is seriously impaired due to the disease we are considering.

As a classic, one might say, symptom, in this case we consider pain that occurs in the muscles of the lower extremities when walking. This symptom has a definition corresponding to its manifestation - “intermittent claudication” (which is explained by periodic stops while walking due to the pain that occurs to reduce its intensity). Pain occurs in this case due to the fact that there is a lack of oxygen in the functioning muscles, which, in turn, occurs due to the specifics of atherosclerosis itself.

What is noteworthy is that arterial insufficiency that occurs with this form of atherosclerosis negatively affects not only the functions inherent in the legs, but it also acts as the cause of the development of trophic disorders, in which the nutrition of the lower extremities in particular is subject to disruption. Trophic disorders can manifest themselves in hair loss and skin changes (thinning, pallor). Nails are subject to deformation and become brittle. In severe cases, atherosclerosis of the legs is accompanied not only by muscle atrophy, but also by the formation of trophic ulcers in combination with gangrene.

Arterial insufficiency of the legs manifests itself in accordance with the disorders that determine its main four stages.

Stage I . In this case, pain in the legs appears only in combination with significant physical activity (for example, this can be walking over long distances (one kilometer or more)).
Stage II . In this case, the maximum distance for pain to occur is reduced, amounting to no more than 200 meters, after overcoming which, accordingly, pain appears.
Stage III . Here pain occurs when walking within a distance of no more than 25 meters, or even at rest.
IV stage . At this stage, patients develop trophic ulcers and gangrene of the lower extremities develops.

Another sign corresponding to the manifestations of atherosclerosis is the disappearance of the pulse noted in the area of the arteries of the lower extremities (this may be the area on the back of the inner ankle, the area of the popliteal fossa or the thigh area).

Thrombosis of the iliac arteries and the terminal part of the abdominal aorta provokes the development of Leriche syndrome.

Leriche syndrome is accompanied by impaired blood circulation, which is relevant for the arteries of the lower extremities, as well as for organs concentrated in the pelvic area. Quite often this syndrome develops against the background of atherosclerosis of the aorta. The manifestations of this pathology are similar to those that occur with atherosclerosis of the vessels of the legs.

In addition, impotence may develop, which, as is understandable, is relevant for men. Obliterating atherosclerosis of the vessels of the lower extremities can act as a serious type of trophic disorder directly affecting the limbs (legs), which can also lead to the development of gangrene, and, ultimately, to the loss of one of them. Accordingly, any warning sign may be a reason to contact a specialist.

Atherosclerosis of the coronary arteries of the heart: symptoms

This form of the disease acts as the main cause of the development of coronary heart disease in patients, which, in turn, develops against the background of impaired blood supply to the heart muscle. Myocardial infarction and angina pectoris are pathologies that directly depend on the degree of development of atherosclerosis affecting the arteries of the heart. Thus, with partial blockage, coronary disease develops (of varying severity of its own manifestation), and with complete blockage, myocardial infarction develops.

Dwelling on the features of the pathology that interests us, which is atherosclerosis of the coronary arteries of the heart, we will highlight the features of the blood supply to the heart. It is provided in particular by two coronary arteries that follow from the aorta. With any disturbance that occurs during blood circulation through the coronary (coronary) arteries, the work of the heart muscle is accordingly disrupted. This, in turn, can trigger a heart attack.

Most often, blood circulation is disrupted due to atherosclerosis of the coronary arteries. In this case, this pathology is accompanied by the formation of dense plaques, due to which the artery wall gradually becomes deformed and destroyed while its lumen narrows (a typical picture of the course of atherosclerosis). Symptoms of atherosclerosis of the coronary arteries correspond to those symptoms that appear with coronary artery disease, but in any case the main cause is atherosclerosis.

The main manifestations of symptoms, accordingly, in this case are the development of angina pectoris and ischemic heart disease; cardiosclerosis and myocardial infarction act as complications of atherosclerosis of the heart vessels. An attack of angina pectoris, which manifests itself in this form of atherosclerosis, is characterized by the following manifestations of symptoms:

the appearance of burning, pressing pain in the chest area; spreading of such pain to the left shoulder and to the back; occurrence - when stressful situations occur or during physical activity;
shortness of breath (a feeling of lack of air appears, which is usually accompanied by the above-mentioned attack of pain; in some cases, there is a need to take a sitting position, because the patient simply begins to choke while lying down);
The appearance of symptoms such as headache, nausea, vomiting and dizziness is considered as a possible option to complement the picture of the attack.

Treatment of an angina attack is ensured by the patient taking nitroglycerin; moreover, it is this drug that is the main one in considering the emergency relief of an attack.

In case of complications such as myocardial infarction Patients experience intense pain, reminiscent of those that occur with angina pectoris. The difference is that the use of nitroglycerin does not determine the corresponding effect. As additional manifestations of symptoms, severe shortness of breath is noted, the patient may lose consciousness. The manifestation of heart failure is characterized by its own severity.

If a complication such as cardiosclerosis, then heart failure manifests itself gradually, which is accompanied by a decrease in physical activity combined with shortness of breath and the occurrence of swelling.

Determination of specific signs corresponding to atherosclerosis of the coronary arteries can only be done using special diagnostic techniques.

Atherosclerosis of mesenteric vessels: symptoms

This form of atherosclerosis manifests itself predominantly in the upper abdomen. The time of onset of symptoms, which primarily consists of the appearance of pain, mainly occurs in the late hours, in particular after dinner. The duration of pain can range from several minutes to up to an hour. As accompanying symptoms, bloating and belching may also occur, and constipation may occur. Pain in atherosclerosis, when compared with the pain syndrome accompanying peptic ulcer disease, is not so long-lasting in its manifestation.

The main symptoms accompanying atherosclerosis in this form include the following manifestations:

bloating;
moderate manifestation of pain, determined by palpating the abdominal area;
mild muscle tension in the anterior abdominal wall;
weakening of peristalsis or its complete absence.

The listed manifestations are defined as such a condition as “angina pectoris”. It develops due to a discrepancy between the volume of blood required to provide blood supply to the organs of the digestive system and the actual volume, which, as can be understood, is insufficient for this.

As one of the complications of this form of atherosclerosis, thrombosis developing in the mesenteric vessels can be noted. As a rule, it appears suddenly, accompanied by the following accompanying symptoms:

constant pain of a wandering or diffuse nature that occurs in the abdomen;
pain in the navel area;
nausea, repeated vomiting (with an admixture of bile; blood may also be present, which is noted in this case in the stool);
constipation, flatulence (gas).

Often, thrombosis of mesenteric vessels results in the development of intestinal gangrene, which, in turn, is accompanied by severe symptoms of peritonitis.

Atherosclerosis of the renal arteries: symptoms

This form of atherosclerosis becomes the cause of the development of a persistent form of ischemia, which, in turn, acts as a factor provoking the development of a consistently high form of arterial hypertension.

Some cases of atherosclerosis of the renal arteries are accompanied by the absence of symptoms. Meanwhile, more often the picture of the disease manifests itself in the form of the development of atherosclerotic plaques with simultaneous narrowing of the lumen of the renal artery, against which a secondary form of arterial hypertension develops.

If only one of the renal arteries is affected, we can talk about the slow progression of this disease; the leading manifestation of symptoms in this case is high blood pressure. If the spread of the process affects both arteries at once, then this, in turn, causes the development of the disease of a type in which arterial hypertension is malignant, characterized by rapid progression and a serious deterioration in the general condition of the patient.

Associated symptoms may include abdominal pain and pain in the lumbar region. The duration of pain manifests itself in different ways, in some cases it is about several hours, in others - about several days. Nausea and vomiting may also occur.

Diagnosis

The primary diagnosis of atherosclerosis is carried out by a therapist as part of a standard annual examination of the patient in this area. To do this, blood pressure is measured, risk factors that contribute to the development of atherosclerosis are identified, and body mass index is measured.

As a clarifying measure, the following research methods can be used:

ECG (echocardiography) in combination with ultrasound of the aorta and heart, as well as with special stress tests;
Invasive research methods (coronary angiography, angiography, intravascular ultrasound);
Duplex scanning, triplex scanning (blood flow is examined using ultrasound visualization of blood vessels);
MRI (magnetic resonance imaging), which visualizes atherosclerotic plaques and artery walls.

Treatment

Treatment of atherosclerosis is based on a number of the following principles:

impact on infectious pathogens;
implementation of replacement therapy measures (relevant for women during menopause);
enhancing the removal of cholesterol and its metabolites from the body;
limiting the intake of cholesterol into the body, reducing the synthesis of cholesterol by cells.

Against this background, the lifestyle is subject to adjustments; an additional diet is prescribed, in which, as you can understand, foods containing cholesterol are subject to maximum exclusion.

As for drug treatment, it is based on taking the following types of drugs:

nicotinic acid in combination with its derivatives (providing the possibility of reducing cholesterol and triglycerides in the blood, as well as increasing the content of high-density lipoproteins);
fibrates (drugs of this group reduce the synthesis of the body’s own fats);
statins (provide the ability to reduce cholesterol in the most effective way by influencing the processes of their production by the body itself);
sequestrants (ensure the binding and removal of bile acids from the intestines while reducing cholesterol and fats in cells).

In some cases, atherosclerosis may require surgical treatment, which is important in case of a serious threat or in the development of an acute form of blockage by a thrombus or plaque of an artery. To do this, an endarterectomy (open surgery on the artery) or endovascular surgery (dilatation of the artery, installation of a stent in the area of narrowing, which provides an obstacle to subsequent blockage) can be performed. A severe form of atherosclerosis with damage to the vessels of the heart, against the background of which myocardial infarction can develop, requires coronary artery bypass grafting.

Yandex.Zen

Pneumonia (officially pneumonia) is an inflammatory process in one or both respiratory organs, which is usually of an infectious nature and is caused by various viruses, bacteria and fungi. In ancient times, this disease was considered one of the most dangerous, and although modern treatments make it possible to get rid of the infection quickly and without consequences, the disease has not lost its relevance. According to official data, in our country every year about a million people suffer from pneumonia in one form or another.

Atherosclerosis is a systemic lesion of large and medium-sized arteries, accompanied by the accumulation of lipids, proliferation of fibrous fibers, dysfunction of the endothelium of the vascular wall and leading to local and general hemodynamic disorders.

Diseases of the cardiovascular system threaten humanity with their serious complications: cerebral stroke and acute myocardial injury. The causes of death from these diseases exceed all others. Atherosclerosis is the main pathology that affects the vital organs interested in the blood supply.

More details about what this disease is, why it affects people and what symptoms are characteristic of it are further in the article.

What is atherosclerosis?

Atherosclerosis is a chronic disease of the arteries that occurs as a result of disturbances in lipid metabolism (a wide group of organic compounds, including fatty acids) and is accompanied by the deposition of cholesterol in the inner lining of blood vessels.

Subsequently, this “clogging” causes the walls of the vessels to thicken, the lumen to decrease, their elasticity to be lost, resulting in blockages. Due to the deformation of blood vessels, there is a load on the heart, because it needs more effort to pump blood.

With atherosclerosis, damage occurs to arteries of medium and large caliber, elastic (large arteries, aorta) and muscular-elastic (mixed: carotid, arteries of the brain and heart) types. Therefore, atherosclerosis is the most common cause:

myocardial infarction,
cerebral stroke,
circulatory disorders of the lower extremities, abdominal aorta, mesenteric and renal arteries.

Symptoms of atherosclerosis in their nature and intensity differ significantly from each other depending on the affected organs. Therefore, only a doctor can determine the type of disease and make an accurate diagnosis.

Causes

First of all, we note that the occurrence and subsequent formation of atherosclerosis depends on the following factors:

the state in which the vascular walls are located;
relevance of the genetic hereditary factor;
disorders in fat (lipid) metabolism.

The average age at which atherosclerosis most often affects the human body is 40 to 45 years.

Men are susceptible to atherosclerosis 3 and sometimes 4 times more often than women, this is due to the fact that the prevention of atherosclerosis in the stronger sex is often not taken seriously.

Today, there are five main factors that contribute to the development and further progression of atherosclerosis, these are:

Heredity
Sedentary lifestyle
Metabolic and endocrine disorders (are precursors of the disease)
Nutrition factor (a large amount of fat, protein and cholesterol enters the body with food)
Nervous disorders (alter lipid-protein balance)

The causes of the development of atherosclerosis are:

high blood pressure,
smoking,
elevated blood cholesterol levels.

But the main cause of atherosclerosis is a violation of cholesterol metabolism. The formation of atherosclerosis is a natural process that begins at approximately 10–15 years of age. With age, it may slow down, or it may speed up.

Classification

The process of accumulation of cholesterol complexes and the formation of atheromatous plaques does not give signs of atherosclerosis at first. Nevertheless, affecting, in general, all the vessels of the body, it gives special preference to some. From the point of view of pathogenesis, this can be assumed based on the characteristic signs of certain pathological conditions.

Depending on the activity of the atherosclerotic process, the following are distinguished:

progressive atherosclerosis– the formation of new ones or the growth of existing ones continues, clinical manifestations gradually worsen, the risk of complications is high;
stabilized atherosclerosis– the development and formation of new plaques is suspended, clinical manifestations remain unchanged or regress, the risk of complications is low;
regressing - clinical symptoms decrease, general condition and laboratory blood parameters improve.

Thus, depending on the predominant localization of the process, the following types of atherosclerosis are distinguished:

Atherosclerosis of heart vessels;
Atherosclerosis of the aorta;
Atherosclerosis of cerebral vessels;
Atherosclerosis of the renal arteries;
Atherosclerosis of the abdominal aorta and its branches;
Atherosclerosis of the vessels of the lower extremities.

General damage to all arteries of the body is quite rare. Very often there is blockage of blood vessels in certain organs: the brain and heart, lower extremities or kidneys. The progression of atherosclerosis is expressed in the fact that with intense functional load on the organ, the blood flow to it is insufficient. This leads to unpleasant sensations on the part of the organ.

Duration and rapidity of development of atherosclerosis quite difficult to predict. We can talk about years or a few months. It all depends on the characteristics of metabolism, metabolic rate, the presence of a predisposition to atherosclerosis and diseases that increase the risk of its development, and many other factors.

Stages

In modern cardiology, the following stages of atherosclerosis are distinguished:

First stage. Decrease in the speed of systemic blood flow, growth of fat spots, absence of painful symptoms.
Second stage. Liposclerosis is accompanied by the growth and spread of adipose tissue, a high probability of blood clots and systemic circulation disorders.
Third stage. Atherocalcinosis is accompanied by thickening of atherosclerotic plaques, calcium deposition, vascular deformation and narrowing of the lumen with the risk of blockage.

Symptoms of atherosclerosis

Clinical symptoms are associated with the location and stage of development of atherosclerotic lesions. It has been proven that signs appear when 50% or more of the lumen of the vessel is affected.

Symptoms of atherosclerosis are best considered in accordance with its localization, that is, to describe the manifestations of an isolated form of the disease. This makes it possible to provide some detail, because the signs of atherosclerosis of the aorta and peripheral vessels cannot be absolutely the same.

There is the following classification of common symptoms:

ischemic - unstable tissue ischemia occurs in the form of attacks of angina pectoris (from the heart), intermittent claudication (in the lower extremities);
thromonecrotic - more severe complications appear in the form of stroke, myocardial infarction, gangrene of the feet;
fibrous - cardiologists know of cases of gradual replacement of the muscle fibers of the heart with fibrous tissue with the formation of areas of cardiosclerosis.

The aorta, cerebral vessels, vessels of the lower extremities, coronary (coronary) arteries of the heart, mesenteric and renal arteries are most susceptible to the development of atherosclerosis. The symptoms of atherosclerotic changes in these cases differ and directly depend on the location of the pathological process.

Atherosclerosis	Symptoms and signs
hearts	burning or pressing pain in the chest area, which often radiates to the left shoulder and back; dizziness; severe shortness of breath, due to which the patient often feels that he does not have enough air. In a lying position, the condition worsens to the point that the person simply suffocates and cannot breathe; nausea; vomit.
aorta	manifests itself as gradually increasing arterial hypertension,noises appearing in front of the abdominal aorta in the ascending direction. A complication in this case is insufficient blood supply to the brain and, as a result, dizziness, fainting, and strokes.
abdominal region	Symptoms of atherosclerosis of the abdominal aorta: stool disorders: diarrhea, constipation; (increased gas formation); weak aching pain after eating; long-term weight loss; severe pain in the abdominal region, which does not subside even when taking painkillers; renal failure; increased blood pressure levels.
lower limbs	Muscle pain when walking. The so-called “intermittent claudication”, when the patient is forced to stop while walking in order to wait out a painful attack. Episodic disappearance of pulse. In the affected arteries of the lower extremities. Trophic disorders. They manifest themselves in changes in the skin of the extremities, hair loss, and brittle nails.
brain	noise in ears; headaches (cephalalgia), dizziness; high blood pressure; sleep disorder (or constant desire to sleep) lethargy, increased fatigue; change in personality behavior; increased nervousness, excitability; breathing difficulties, slurred speech, difficulty chewing and swallowing food; problems with coordination of movement, orientation in space; memory impairment; - chest pain, shortness of breath. In addition to the above disorders, it is also necessary to note neurosis-like, or, as they are also called, depressive symptoms: bad mood and increased tearfulness; complete lack of desire to work, study, have fun.
renal arteries	It manifests itself as changes in urine tests and a persistent increase in blood pressure. If both arteries have undergone atherosclerotic changes, in addition to increased blood pressure, the following symptoms are observed: pain in the lower back and abdomen, nausea, vomiting; rise in temperature, chills; serious deterioration in general condition.

Complications and consequences for the body

If atherosclerosis occurs in a complicated form, complications cannot be ruled out even after long-term treatment. The consequences of the operation are especially dangerous, so you need to carefully prepare for surgery, undergo diagnostics and pass all the necessary tests.

Complications with already developed atherosclerosis can be prevented if you take prescribed medications and follow the recommendations of your doctor. If there are concomitant diseases, their treatment is also a mandatory measure in the prevention of complications.

Diagnostics

Treatment of atherosclerosis is usually started by a general practitioner (general practitioner or family doctor), then the patient is taken over by:

Cardiologist, if the process affects the heart, aorta and coronary vessels to a greater extent;
Neurologist when it comes to the vessels of the neck and head;
Nephrologist for kidney damage;
Atherosclerotic lesions of peripheral vessels are usually dealt with by an angiosurgeon.

As a clarifying measure, the following research methods can be used:

ECG (echocardiography) in combination with ultrasound of the aorta and heart, as well as with special stress tests;
Invasive research methods (coronary angiography, angiography, intravascular ultrasound);
Duplex scanning, triplex scanning (blood flow is examined using ultrasound visualization of blood vessels);
MRI (magnetic resonance imaging), which visualizes atherosclerotic plaques and artery walls.

A blood test to determine the level of lipids and cholesterol, especially “bad” cholesterol (it should not exceed 5.2 mmol/l), will be useful. With atherosclerosis, there is an increased level of total cholesterol and a decrease in good cholesterol.

Treatment

Treatment of atherosclerosis is complex, painstaking and quite lengthy. For the patient, the most difficult test is the mandatory abandonment of habits and inclinations that have been established over many years.

The patient must refuse:

usual meals,
change the general mode and diet,
constantly carry out the treatment prescribed by the doctor,
increase motor activity,
normalize living and working conditions, take timely measures to slow down the progression of the disease.

When treating atherosclerosis, the following principles are adhered to:

limiting cholesterol entering the body and reducing its synthesis by tissue cells;
enhancing the removal of cholesterol and its metabolites from the body;
use of estrogen replacement therapy in postmenopausal women;
impact on infectious pathogens.

Limiting dietary cholesterol is done by prescribing a diet that excludes cholesterol-containing foods.
There are three groups of drugs known:

statins (simvastatin, atorvastatin and the strongest rosuvastatin) - the mechanism of action is associated with preventing the production of cholesterol in the liver;
fatty acid sequestrants - block fatty acids and force the liver to spend lipoproteins on digestion;
nicotinic acid - dilates blood vessels, increases blood flow.

Diet

To a large extent, the diet is based on the principles of proper nutrition, which includes fish and vegetable oils - rapeseed, sunflower, soy, olives; You should also include vegetables and fruits, various herbs (basil, oregano, dill).

If you have an abnormal lipid profile, you should limit fat, especially the so-called “bad” fat, which consists of saturated fatty acids and cholesterol. Avoid:

fatty meats, mainly pork, pates, poultry skins, lard;
fatty dairy products (butter, ice cream, full-fat milk), egg whites;
margarine, cream, palm oil.

The menu of a person who cares about the condition of his blood vessels must include:

Seasonal vegetables and fruits, dishes made from them;
Lean meats (lean beef, skinless chicken);
Any fish;
A sufficient amount of non-alcoholic drinks - juices, fruit drinks, compotes, kvass;
Whole grain porridge;
Vegetable oils for preparing first and second courses, salad dressings.

Surgical treatment of atherosclerosis

The determining factor of the further condition, on the basis of which the prognosis for atherosclerosis is considered, is the patient’s lifestyle. If areas of necrosis in combination with acute circulatory disorders begin to develop in the organs against the background of the disease, the prognosis worsens.

In modern medical practice, three main methods of surgical treatment of atherosclerosis have been developed.

Highly invasive	Minimally invasive method
Shunting. The essence of bypass surgery is to suture the affected vessel to a healthy one, due to which a new blood line is formed and the blood supply to the tissue is gradually restored;	Angioplasty. The essence of the method is to insert a specialized catheter through the femoral artery, which, under camera control, is advanced through the bloodstream by an endoscopist to the affected area. After this, the necessary manipulations are performed to clean or expand the vessel.
Vascular prosthetics. Modern materials make it possible to completely replace the affected vessel and restore blood supply functions.

Folk remedies

Before using folk remedies for atherosclerosis, be sure to consult a cardiologist.

Place 50 g of cloves in a glass container, pour in 500 ml of vodka, and leave the composition for 2-3 weeks. Take 1 tsp. infusion three times a day, while making sure that there are no chronic stomach diseases.
You need to mix equal parts of chamomile, St. John's wort, string, plantain and sage, then place 1 tbsp. collection in boiling water (150 ml) for a day. The resulting herbal infusion must be applied to sore spots twice daily.
Honey for atherosclerosis. Mix a tablespoon of honey with the same amount of yogurt, add 2 teaspoons of cinnamon powder. Take the mixture one teaspoon in the morning and evening. The course of treatment is 10-15 days.
Collected by tsp. strawberry leaves, mint, dill, horsetail, dandelion roots and rose hips, combine with 300 ml of boiling water, leave for two hours, then clear the infusion. It should be taken for a month, 150 ml at intervals of 5 hours.
It is useful to use the following folk remedy: 1 tsp. grated horseradish on a fine grater with 2 tsp. honey Take 1 hour before breakfast. The course of treatment is 1 month.

Forecast

In many ways, the prognosis of atherosclerosis is determined by the behavior and lifestyle of the patient himself. Elimination of possible risk factors and active drug therapy can delay the development of atherosclerosis and achieve an improvement in the patient’s condition. With the development of acute circulatory disorders with the formation of foci of necrosis in organs, the prognosis worsens.

Prevention

Primary prevention of atherosclerosis involves:

Control and achievement of target cholesterol levels (total cholesterol up to 5 mmol/l, LDL cholesterol below 3 mmol/l).
Quitting smoking, drinking alcohol, and taking drugs.
Adequate level of physical activity.
Normalization of body weight.
Limiting emotional overload.
Normal blood glucose levels.
Blood pressure below 140/90 mmHg.
Compliance with the principles of an antiatherosclerotic diet.

What is secondary prevention?

A set of purely medical measures aimed at inhibiting atherosclerotic processes in the vessels of the brain, heart and lower extremities with an existing disease is called secondary prevention, the purpose of which is:

Reducing A/D indicators to at least 140/80 mm. rt. Art.;
Constant use of antiplatelet agents – clopidogrel and aspirin;
Prescribing statins to achieve normal levels of lipids in the blood (this figure is approximately 2.6 mmol/l, for some patients a figure of 4-4.5 mmol/l is acceptable).

Atherosclerosis - symptoms and treatment

What is atherosclerosis? We will discuss the causes, diagnosis and treatment methods in the article by Dr. Vitaly Konstantinovich Zafiraki, a cardiologist with 19 years of experience.

Publication date February 13, 2018Updated October 17, 2019

Definition of disease. Causes of the disease

Atherosclerosis- a systemic disease that initially affects blood vessels, but not all of them, but only the arteries, in the walls of which cholesterol and its esters accumulate, forming plaques characteristic of this disease.

Subsequently, as the ability of blood vessels affected by atherosclerosis to deliver the amount of blood necessary for the functioning of internal organs decreases, these organs themselves are affected. This can occur either slowly and gradually - due to the growth of atherosclerotic plaques, or acutely - with the development of vessel thrombosis.

In medicine, a strange situation has arisen when, for atherosclerosis affecting a number of organs, there are names of corresponding “diseases,” although in fact the disease is the same: atherosclerosis, and only the predominant localization of the process may be different. In particular, in the presence of symptoms of damage to the arteries of the heart (coronary), they speak of coronary heart disease (CHD), with symptomatic damage to the arteries supplying blood to the lower extremities - about atherosclerosis of the arteries of the lower extremities ("intermittent claudication"), and, for example, when an atherosclerotic plaque ruptures and thrombosis of one of the vessels supplying blood to the brain - ischemic atherothrombotic stroke.

The occurrence and development of atherosclerosis cannot be reduced to any one causal factor - usually it is an interweaving of causes. However, among all the reasons, we can distinguish those that are associated with a person’s genetic characteristics and those that are caused by lifestyle. In cases associated with “genetic damage,” no other reasons may be required for the development of the disease, and the disease may be very malignant in nature, when, for example, myocardial infarction or stroke occurs in the third or fourth decade of life, and life itself is significantly shortens. This is possible with so-called familial hypercholesterolemia, in which lipid complexes containing cholesterol moving in the blood are poorly captured by tissues (primarily the liver). As a result, the concentration of these particles and, accordingly, cholesterol in the blood increases, and excess cholesterol, as well as its esters, ultimately end up in the artery wall. Of course, this process is much more complicated and is actually multi-stage, but its final result is the formation of atherosclerotic plaques in the walls of blood vessels. An increase in the concentration of cholesterol-containing particles in the blood may much more often occur not due to genetic damage, but due to an unhealthy lifestyle. This is greatly facilitated by certain types of food (fast food, many processed foods, fatty meats and fatty dairy products, margarines, products with palm oil, etc.).

If you notice similar symptoms, consult your doctor. Do not self-medicate - it is dangerous for your health!

Symptoms of atherosclerosis

Atherosclerosis occurs without symptoms for a long time (years and decades). Moreover, many vessels are usually gradually affected, since atherosclerosis is a systemic disease. If an atherosclerotic plaque is found in some part of the vascular bed, most likely there are plaques in other vascular beds. The appearance of symptoms is primarily associated with manifestations of decreased blood flow in the affected vessel. If such a lesion is associated with chronic restriction of blood flow, symptoms of chronic ischemia (consequences of decreased blood flow) of the corresponding organ occur.

For example, if atherosclerotic plaques of significant size restrict blood flow in the vessels of the heart, so-called “angina pectoris” develops - chest pain or discomfort (heaviness, burning, squeezing in the chest) during physical activity - walking, running, lifting heavy objects. If the same thing happens in the arteries of the lower extremities, symptoms develop that are called “intermittent claudication,” in which pain, burning, or severe fatigue appears in the leg muscles while walking. These symptoms go away quite quickly if you stop, but appear again after a while when you continue to walk.

Pathogenesis of atherosclerosis

The amount of dietary cholesterol does not play any significant role in the development of atherosclerosis, contrary to what has existed for many decades. Therefore, there is no scientific basis for limiting dietary cholesterol, and all the advertising hype surrounding the fight against dietary cholesterol is meaningless. The fact is that almost all cholesterol is formed within us - largely under the influence of what we eat, and the types of food listed above contribute to the accelerated synthesis of our own cholesterol.

Cholesterol itself is a vital substance, and each of our cells is capable of synthesizing it as needed. But when the body’s ability to use and utilize its cholesterol decreases, then its concentration in the blood increases, with all further consequences. The ability to utilize your own cholesterol is reduced by factors that change the chemical composition of lipid particles, which include cholesterol. These are, for example, smoking, diabetes, chronic inflammation. These same factors damage the walls of blood vessels, thereby facilitating the penetration of cholesterol-containing lipid blood particles into them.

The growth of atherosclerotic plaques is a process that extends over many years and decades. If a plaque in the wall of a vessel reaches a significant size (about 70% of the lumen of the vessel or more), it can create significant obstacles to blood flow and to the blood supply to the corresponding organ - for example, the heart or brain. Plaques that are small in size are also unsafe - when such plaques rupture (this is possible in cases where their “tire” becomes thinner for various reasons), a blood clot forms at the rupture site, which can completely block the lumen of the vessel. In this case, due to a sharp restriction of blood flow, the death of a significant number of cells in the organ supplied by the vessel occurs - a heart attack (for example, myocardial infarction or cerebral infarction - stroke).

Complications of atherosclerosis

In cases where the volume of blood flow through the affected artery decreases quickly - and this happens in the case of rupture of an atherosclerotic plaque and the formation of a blood clot in this area - symptoms associated with damage to the corresponding organ develop just as quickly: myocardial infarction, stroke, gangrene of the lower limb, etc. .

Diagnosis of atherosclerosis

To one degree or another, most adults living a modern “Western” lifestyle have atherosclerotic plaques in the walls of their arteries, but not all of them reach the stage where clinical symptoms appear. If there are no clinical symptoms that can be associated with a decrease in blood flow through certain arteries, the doctor nevertheless assesses the risk of atherosclerosis and death from diseases associated with it by identifying so-called risk factors for atherosclerosis. The most important of them include male gender, age (with each passing decade, the risk of diseases associated with atherosclerosis increases), high blood pressure, high cholesterol levels (especially low-density lipoprotein cholesterol), smoking, diabetes mellitus, obesity, and a number of genetic disorders etc. The risk of death from diseases associated with atherosclerosis over the next 10 years can be calculated individually for yourself using an electronic calculator. The risk is considered high if it exceeds 5%. 5% doesn't seem like much. However, it must be taken into account that this is a risk of death. The risk of non-fatal diseases that threaten to develop during this period is 3-5 times higher. Moreover, the actual risk is usually higher than the calculated one, since the calculator takes into account only 5 main risk factors, and there are many more of them. For example, the presence of diabetes mellitus increases the estimated risk in men by 3 times, and in women by 5 times!

Since the most important risk factor for atherosclerosis of any localization is an increased level of cholesterol in the blood (especially low-density lipoprotein cholesterol), a blood test called a “lipid profile” (under the umbrella of “biochemical blood test”) is usually performed. This involves not only measuring the concentration of total cholesterol, but also its distribution into two (and now available three) lipoprotein fractions: low-density lipoprotein cholesterol and high-density lipoprotein cholesterol. In addition, a lipid profile involves measuring the concentration of triglycerides (fats) in the blood. As a result, it is possible to more accurately assess the risk of diseases associated with atherosclerosis and identify targets for therapeutic interventions. The disorders identified in the lipid profile are not in themselves synonymous with the disease “atherosclerosis,” but they increase the risk of this disease to a greater extent, the more severe the identified biochemical disorders.

Atherosclerotic lesions of the arteries themselves require various instrumental studies to be identified, depending on the location of atherosclerosis the doctor suggests. The most accessible location for identifying atherosclerosis is the carotid arteries. To do this, they perform an ultrasound examination (triplex scanning of the brachiocephalic arteries). This study allows us to assess the condition of the vascular wall, extrapolating these data more or less successfully to the entire arterial vascular bed. The implication is that if atherosclerotic plaque is present in the carotid arteries, it is likely that there is plaque in other vessels as well, so this patient will likely require cholesterol-lowering medications and interventions to address other risk factors for atherosclerosis (eg, blood pressure, weight, smoking).

It is quite simple to assess the presence of atherosclerotic plaques in the vessels of the legs. This is done using the same ultrasonic method. Plaques located in the vessels of the heart are more difficult to see. However, only those plaques in the coronary vessels that significantly block the blood flow, causing symptoms, are important for making treatment decisions - in the case of chronic damage to these vessels, we are talking about “angina pectoris,” which is identified by analyzing the existing clinical manifestations (typically pain or chest discomfort that occurs when walking, running, or lifting weights and resolves within a few minutes with rest) and performing an exercise test during which an electrocardiogram, echocardiogram, or scintigraphic image of the heart is recorded in order to identify objective signs of ischemia, i.e. temporary discrepancy between blood delivery to the myocardium and the need for it during exercise. In cases where the doctor decides that there are indications for surgery on the heart vessels, coronary angiography is performed - an x-ray examination of the heart vessels with the introduction of a contrast agent, during which one can directly see the lumen of the heart vessels and the narrowings present in these vessels, in order to outline an operation plan and select its option.

Treatment of atherosclerosis

It is necessary to separate, on the one hand, those measures that are aimed at preventing atherosclerosis and slowing down the rate of its development/progression, and, on the other hand, measures for the treatment of diseases based on atherosclerotic lesions of the arteries.

Nowadays, it is not yet possible to correct those “breakdowns” at the gene level, due to which the development of atherosclerosis is accelerated in some people. Therefore, in order to stop or slow down its development, therapeutic and preventive interventions for atherosclerosis are aimed mainly at reducing the negative impact of risk factors for atherosclerosis, including achieving a decrease in the level of cholesterol in the blood, and above all, that same “bad” lipoprotein cholesterol low density. Reducing the level of cholesterol in the blood and, most importantly, maintaining it at an optimal level for many years can stop the progression of atherosclerosis and even partially reverse it. These activities are carried out both as part of lifestyle improvement and in the form of drug treatment. However, most people are usually not ready for serious changes in their lifestyle and rely more on some external influences that doctors could perform on them, or on self-medication measures. There are a huge number of misconceptions and myths on this score, ineffective supposedly “therapeutic” measures, drugs and dietary supplements. Neither red wine, nor lard, nor garlic tincture, nor laser irradiation of the blood, nor monitor cleansing of the intestines, as well as a huge number of other “therapeutic” measures, are capable of treating atherosclerotic vascular damage.

Of the drugs with proven effectiveness that can inhibit the development and progression of atherosclerosis, as well as to a certain extent cause its reverse development, the largest evidence base is statins (atorvastatin, rosuvastatin, pitavastatin, simvastatin). Statins not only reduce the level of total cholesterol and cholesterol contained in low-density lipoproteins, but due to this, with long-term use, statins can stop or slow the growth of atherosclerotic plaques, reduce the risk of myocardial infarction and stroke, and also increase life expectancy in diseases associated with with atherosclerosis. In order to expect such effects, statins must be taken for a number of years and in the correct doses, which were established in those clinical studies that found the beneficial effects of statins.

There are other medications that improve blood biochemical parameters, which reflect the lipid profile, and thereby reduce the risk of diseases and complications associated with atherosclerosis. In addition to statins, this ezetimibe (ezetrol), which prevents the absorption of dietary cholesterol in the intestines, as well as recently appeared kumbs - antibodies to an enzyme discovered in 2003, abbreviated as PCSK9 (evolocumab and alirocumab are registered in Russia). To simplify, we can say that this enzyme - PCSK9 - regulates the rate of absorption of cholesterol contained in the blood by liver cells. True, kumbs are currently very expensive, but this is their only drawback. There are other groups of drugs that can influence the lipid profile towards its improvement, but their significance is significantly less.

Forecast. Prevention

For the treatment and prevention of atherosclerosis, it is important to influence all the main causative factors (risk factors) of its development:

In cases where the development of atherosclerosis reaches the stage at which clinical symptoms of a particular disease associated with atherosclerosis appear, this disease itself begins to be treated, or, more precisely, atherosclerotic damage to one or another organ: heart, brain, kidneys, lower limbs. Moreover, this treatment can often be surgical. Typically, such treatment consists of surgical interventions that locally restore the patency of arteries affected by atherosclerosis. For example, in case of damage to the vessels of the heart, this may be a low-traumatic operation to install a special intravascular frame at the site of narrowing - a stent, which is carried out through a puncture in the vessel, or it may be a “major” coronary bypass surgery with opening the chest and imposing bypass paths for blood flow in the heart - shunts. At the same time, atherosclerosis remains as a systemic disease, and surgical treatment in no way eliminates the need to treat it - first of all, by correcting risk factors, among which the disturbed ratio of lipoprotein fractions containing cholesterol is extremely important.

Atherosclerosis is an insidious chronic inflammatory process that mainly affects large and medium-sized arteries in response to the accumulation of cholesterol in these vessels.

Abnormal changes often begin in childhood and progress over many years without any symptoms. Therefore, it is important to adhere to a proper diet and lifestyle from an early age, since with their help the development of atherosclerosis can be controlled.

The disease can underlie many diseases, such as coronary heart disease, stroke, diseases of peripheral vessels, for example: stenosis of the carotid artery, vertebral arteries, renal and chronic ischemia of the lower extremities.

Many people have signs of the disease but do not know what it is. Atherosclerosis is a process of inflammation; This is a response to damage to the inner layer of the vessel walls, resulting in the formation of a fatty layer consisting of inflammatory cells.

A necessary condition for the normal functioning of the organs and tissues of the body is the correct amount of oxygen and nutrients. Restriction of blood flow leads to dangerous consequences.

If the flow in the coronary arteries is reduced after a heart attack, the blood flow in the carotid artery decreases, which causes an ischemic stroke in the arteries of the lower extremities, leading to their necrosis.

The cause of arterial stenosis and occlusion is atherosclerosis, a disease caused by the deposition of cholesterol on the walls of arteries and the formation of atherosclerotic plaques, which cause narrowing of the lumen of blood vessels, which leads to occlusion.

Depending on the location of plaque formation, there are four main types of atherosclerosis:

Arteries;

Peripheral;

Coronal;

Cerebral.

Causes

The true causes of the disease are still unknown to medicine. It has been established that for the formation of atherosclerotic lesions, the occurrence of certain factors is necessary, such as genetic (out of control), environment, area of residence (some ethnic groups are more or less susceptible to the disease) and lifestyle (what we eat, habits).

A variety of these factors contribute to different clinical atherosclerosis.

Risk factors for development

The main risk factors for developing atherosclerosis include:

1. Unchangeable factors:

2. Modifiable factors, which mainly include various concomitant diseases:

excessive consumption of animal fats and high levels of total cholesterol;
hypertension;
bleeding disorders;
stress;
impaired glucose tolerance or diabetes mellitus;
low physical activity;
obesity;
smoking.

Atherosclerosis appears in the brain, heart, kidneys and lower extremities, but symptoms are only visible when plaque builds up and interferes with blood flow.

Risk factors lead to vascular damage and, consequently, to increased penetration of cholesterol molecules into the arterial walls. Their restoration involves special cells that interact with each other in a special way.

Subsequently, scar tissue forms at the site of injury, compressing the arteries and reducing blood flow. With atherosclerosis, continuous inflammation of cells occurs, which over time destroys all layers of the artery walls.

Symptoms of atherosclerosis can be seen in the photo, and treatment should begin immediately. The disease develops unnoticed and secretly. However, there are certain signs that indicate an illness.

The following symptoms are reasons to consult a doctor:

pain as if the chest is compressed, can spread to the arms, neck, jaw;
cardiac arrhythmia;
breathing problems (angina);
dizziness, severe and frequent headaches;
loss of consciousness;
vision problems;
renal failure;
feeling of freezing feet.

Lower extremity symptoms (chronic ischemia)

As a result of atherosclerosis in the vessels of the lower extremities, a narrowing of the flow into the femoral artery often occurs, which can lead to ischemia of the thigh, leg and foot. A decrease in the functions of the main artery, which supplies blood to the lower extremities, leads to cell hypoxia and the development of collateral circulation, that is, it creates additional clogging of blood vessels.

This condition causes oxygen-free muscles to begin producing so-called anaerobic energy, which leads to excessive production of lactic acid, which is the main symptom of ischemia - painful sensations in the limbs.

Then numbness of the limbs appears, especially in a lying position, at night. Other symptoms are:

pale skin;
atrophy of muscles and hair on the leg and lower leg;
keratosis;
ulcers;
necrosis.

Symptoms of atherosclerosis of the carotid arteries

Atherosclerosis of the carotid arteries causes deterioration of blood supply to the brain and oxygen starvation of nerve cells, disrupting their functioning. Symptoms depend on the degree of stenosis. A slight narrowing may be asymptomatic.

If there is a significant decrease in blood flow, the following occurs:

numbness of the body;
slurred speech;
loss of vision and hearing;
deterioration of movement coordination;
muscle weakness, paresis.

Complete closure of the carotid artery can lead to a stroke.

Symptoms of vertebral artery stenosis

Impaired blood flow through the vertebral arteries can often cause dizziness, double vision, and loss of vision. In more serious cases, it can lead to respiratory problems and coma.

Symptoms of chronic mesenteric ischemia

This disease is caused by atherosclerosis of the arteries that supply blood to the intestines. Symptoms include:

Abdominal pain that occurs after eating;

Weight loss;

Dyspepsia - nausea, vomiting and diarrhea.

Progressive vascular disease, regardless of the causes of atherosclerosis, leads to narrowing of the lumen and disruption of blood flow, which contributes to ischemia of the organ or tissue. Signs of the disease also depend on the location, size and severity of the changes.

The location of atherosclerotic vascular lesions ultimately affects the consequences of the disease:

change in the aortic arch - impedes blood flow to the upper extremities, leading to Takayashi's disease;
changes in the thoracic and abdominal aorta, including the renal arteries, mesenteric and bifurcation arteries, lead to secondary hypertension, ischemia of the digestive tract or lower extremities (Leriche syndrome);
narrowing of a stenotic vessel in the internal carotid or cerebral artery, causing disruption of blood circulation in the brain, which can lead to areas of brain inflammation or disorders of the central nervous system.

It is impossible to diagnose the disease using one test. Most often, it is recognized by characteristic symptoms and the presence of a risk factor.

Varicose veins can be detected using ultrasound, which shows thickening and narrowing of blood vessels, but only when the disease has already progressed. It is also effective to perform a Doppler ultrasound, which checks for areas where blood flow is disrupted. The coronary arteries can be assessed using computed tomography, magnetic resonance imaging, or classical angiography.

To answer the question of how to treat atherosclerosis, you should know what kind of disease it is. Atherosclerosis cannot be cured completely. Since it is a disease of the whole body, its therapy should be comprehensive and long-term, aimed at reducing symptoms and progression.

Most often, pharmacological therapy is combined with physiotherapy. The goal of treatment is to ensure sufficient blood supply by activating and improving the circulation of blood along the walls of the arteries.

When treating arterial diseases, it is recommended to use drugs that regulate blood cholesterol levels. Sterols and stanols reduce the absorption of cholesterol from the intestine. Statins are medications that lower cholesterol and triglyceride levels and delay the progression of the disease.

Another group of drugs that are used to treat atherosclerosis are anticoagulants (for example, acetylsalicylic acid), which prevent platelets from sticking together and forming blood clots. In small doses, these medications are recommended for the prevention of strokes, myocardial infarction and diseases of the lower extremities. Their use is stopped several days before planned surgery due to the increased risk of bleeding.

In the treatment of patients with atherosclerosis of the lower extremities, drugs that inhibit blood clotting, such as heparin, are sometimes used.

Invasive methods

Sometimes it happens that surgery is necessary to improve or restore the patency of the artery. It usually involves removing clots and atherosclerotic plaques from the cavity.

A less invasive method is through the skin. The most commonly used method of intravascular dilatation of narrowed arteries is balloon angioplasty. This procedure involves inserting a catheter into an artery. Under pressure, the blood clot and atherosclerotic plaques in the arterial wall dissolve, while at the same time the artery walls stretch. After this, the catheter is removed.

Another approach is to insert a permanent stent, whose task is to support the arterial wall from the inside.

How to treat the mild stage of the disease? The most important step is to reduce your blood cholesterol levels to less than 4.0 mmol/L. This is facilitated by the exclusion of fatty foods and simple sugars, the inclusion of foods rich in plant sterols, allicin, flavonoids, fiber and omega-3. As the disease progresses, surgery is often required.

As part of the treatment with folk remedies, hawthorn flowers, rue leaves, mistletoe, onions, garlic, buckthorn bark, and violets are used. The herbs can be brewed separately or added to tea.

Prevention of atherosclerosis

When preventing atherosclerosis, it is important to exclude risk factors for this disease. Regular moderate exercise is also important.

Long walks, swimming, cycling develop collateral circulation in the limbs and increase the permeability of blood vessels.

Healing diet

If you have an abnormal lipid profile, you should limit fat, especially the so-called “bad” fat, which consists of saturated fatty acids and cholesterol. Avoid:

For a patient with atherosclerosis, proper treatment of concomitant diseases is important, including:

diabetes;
hypertension;
dyslipidemia (abnormal blood cholesterol levels);
cardiac ischemia;
obesity.

In addition, patients with atherosclerosis should avoid burns, frostbite, cuts and other injuries.

Learn more about which products will help in the fight against atherosclerosis:

Development forecast

Atherosclerosis is a disease that progresses throughout life. If you limit risk factors as much as possible, you can delay its development. This is possible with appropriate treatment and compliance with medical recommendations.