What it is

Atherosclerosis is an inflammatory condition characterized by the formation of plaques composed of fat, calcium, and other substances on the walls of arteries in the heart and other parts of the body, such as the brain and lower limbs. These plaques can be diffuse or localized. The disease is marked by the narrowing and hardening of the arteries due to the accumulation of fat in their walls, known as atheroma.

Over time, these plaques grow, narrowing the blood vessels and potentially leading to complete blockage, which restricts blood flow to the affected area.

As a result, the affected tissue receives less oxygen and nutrients, compromising its function. This complication is the cause of various cardiovascular diseases, such as heart attacks, sudden death, and strokes, and is the leading cause of death worldwide.

Causes and Risk Factors

In most cases, atherosclerosis is associated with traditional risk factors such as physical inactivity, poor diet, high blood pressure, diabetes, high cholesterol, smoking, and obesity.

A small portion of cases is hereditary, such as in individuals with familial hypercholesterolemia, where members of the same family have very high cholesterol levels from childhood.

Symptoms

Atherosclerosis is a dangerous disease because it often progresses silently. Some people only discover the presence of fatty plaques when an artery becomes completely blocked and emergency care is needed. These are the cases of heart attacks, strokes, and even sudden death.

When symptoms do appear, they depend mainly on the location of the blockage. When it affects the heart, the most common symptoms are chest pain (pressure, tightness, burning, or stabbing), shortness of breath, and sweating.

Diagnosis

In many cases, diagnosis occurs during an emergency, such as after a heart attack or stroke. Ideally, everyone should see a doctor for regular check-ups to screen for and manage risk factors for atherosclerosis.

By identifying these risk factors, it is possible to determine the likelihood of developing the disease. Patients with a high probability of atherosclerosis or with compatible symptoms may require further evaluation through more specific tests, such as a stress test, scintigraphy, CT scan, or cardiac catheterization.

Treatment

The best treatment for atherosclerosis is still prevention, through a healthy lifestyle and management of risk factors. Once established, treatment generally aims to restore blood flow to the affected area, often requiring medication, invasive procedures, and/or revascularization surgeries.

When it affects the heart and its vessels, drug treatment is essential, including antiplatelet agents (such as aspirin), statins, vasodilators, and other medications. Angioplasty and coronary artery bypass surgery may also be used when appropriately indicated.

Prevention

As with most cardiovascular diseases, the best form of prevention is to maintain a routine that includes regular physical activity, a balanced diet, quitting smoking, and low intake of fats and salt, along with controlling risk factors for conditions such as obesity, diabetes, hypertension, and high cholesterol.

By the Einstein Editorial Board