cholesterol > atherosclerosis

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Most people will develop some arterial deposits over time, but certain factors significantly encourage this process. These are called risk factors:

Age. the risk of developing atherosclerosis increases after age 35, although it can begin much earlier. Blood vessels lose a certain amount of elasticity with aging.

Gender: premenopausal women are much less likely than men of the same age to have atherosclerosis, but after menopause women's risk increases to equal or even exceed that of men.

Heredity. a family history of atherosclerosis or other circulatory diseases may denote increased risk in closely related family members.

Obesity.: Obese people are more likely to have atherosclerosis because they are predisposed to high triglyceride, low HDL-cholesterol and raised total cholesterol, high blood pressure, thrombus formation and diabetes mellitus.

Physical inactivity

Diabetes mellitus.

High level of blood cholesterol (hypercholesterolaemia): especially that cholesterol carried in LDL or low-density lipoproteins from the liver to the tissues.

Low levels of high-density lipoprotein (HDL) which transport cholesterol from cells to the liver are also associated with a high risk of heart disease. This is often associated with raised concentrations of triglyceride (also a fatty substance similar to cholesterol).

Hypertension (high blood pressure).

Smoking:a smoker's risk of coronary artery disease is directly related to the number of cigarettes smoked daily. In people who already have a high risk of heart disease, smoking is particularly dangerous.

Smoking:

decreases the level of "good" HDL cholesterol and increases the level of "bad" LDL cholesterol.

raises the blood carbon monoxide level, which may increase the risk of injury to the lining of arterial walls

constricts arteries already narrowed by atherosclerosis, further decreasing blood flow to the tissues

increases the blood's clotting tendency, thus increasing the risk of peripheral arterial disease, coronary artery disease, stroke and obstruction of an arterial graft after surgery.

What are the symptoms and signs of atherosclerosis?

Atherosclerosis usually produces no symptoms until arterial narrowing significantly reduces blood supply to an organ. This may be partial or complete, acute or chronic. Complete obstruction is generally the result of a thrombus or an embolus. The symptoms and outcome (prognosis) will vary accordingly.

The first symptom of a narrowed artery is generally pain at times when the blood flow can't keep up with the tissue’s demand for oxygen. For instance, during exercise, you may feel chest pain (angina) because of lack of oxygen to the heart; or leg cramps because of lack of oxygen to the leg muscles. Typically, these symptoms develop gradually and episodically as the artery is slowly narrowed. However, when an obstruction occurs rapidly the onset of symptoms is sudden and severe. This may be the presenting event without previous warning symptoms.

Symptoms may be quite characteristic or atypical. The more characteristic clinical presentations are described below which depend on the organ mainly affected and the severity of the obstruction:

Heart

A pressing, centrally located, chest pain (angina)which may be felt in the arms and hands as tingling or numbness.

shortness of breath

Less characteristic features include: sweating

nausea

dizziness or lightheadedness

palpitations

Brain

Chronic atherosclerosis of cerebral arteries do not present with pain but may cause progressively diminished mental functioning and episodes of lightheadedness especially on rising suddenly.

It may also present with very minor strokes called transient ischaemic attacks accompanied by temporary dizziness or confusion, incoordination, numbness and loss of speech. These features are relieved within 24 hours.

An acute more severe obstruction or bleed may present with:

Headache – often severe and sudden

Unconsciousness and collapse

Weakness or paralysis on one side of the body

Sudden, severe numbness in any part of the body

Speech and visual disturbances or severe muscle incoordination.

The presentation may be progressive over a short period of time or may be sudden and overwhelming. In the case of a stroke the neurological abnormalities are persistent often taking months to improve; full restoration of normal function is rare. Strokes can result in a bizarre variety of neurological problems, sometimes very localised and specific.

Legs

Crampy pain in the leg muscles, especially during exercise which temporarily improves on resting

If narrowing is severe, the skin may be cool and pale or ‘blue’ with hair loss on the legs, thickened toenails and absence of peripheral pulses in the legs and feet. A noise (bruit) may be heard over arteries in the groin using a stethoscope.

Abdomen

Dull or cramping pain in the middle of the abdomen, usually beginning 15 to 30 minutes after eating

Severe abdominal pain, vomiting, diarrhoea or constipation caused by complete blockage of an artery in the intestine.

(published with permission in writing from:http://www.health24.com/)