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A Series by David Grubin

Atherosclerosis, How To Keep A Silent Killer At Bay

By Dr. Peter Libby

The build-up of plaque
The build-up of plaque over time damages
the artery walls.
Atherosclerosis, commonly called hardening of the arteries, causes heart attacks and many strokes, and ravages many other of the body's organs as well. Unfortunately, atherosclerosis is on the rise worldwide and threatens to become a major cause of death, disability, and loss of useful life years not only in Western societies but in the developing world as well. Fortunately, there is much that an individual can do to reduce their risk of suffering from atherosclerosis and its complications.

What is Atherosclerosis?

Our arteries supply blood pumped by the heart to all of the body's tissues and organs. These remarkable structures are not just lifeless tubes that conduct the blood. Rather, our arteries are living structures populated by specialized cells that have numerous functions to maintain our arteries in a healthy state under normal conditions. However, when perturbed, arteries can be the sites of development of fatty buildups known as plaque. In recent years, researchers have uncovered many of the steps that lead a normal artery to become the site of formation of a fatty plaque or atherosclerotic lesion. To understand how and why these plaques form and what we can do about it, we must understand the concept of "risk factors" for atherosclerosis.

"Risk Factors" for Atherosclerosis
Atherosclerotic lesion
Atherosclerotic lesions are like pimples
that form in artery walls.

Careful observation of large populations has uncovered a number of "risk factors" for atherosclerosis that predict plaque development and the complications that they cause, such as heart attack and stroke. When the doctor measures your blood pressure, he gains important information about your risk for artery disease.

  • High blood pressure - The higher the blood pressure, the more likely an individual will develop fatty plaques and their complications. Cholesterol measurements in the blood similarly correlate with cardiovascular risk.
  • Cholesterol - The higher an individual's level of cholesterol, particularly when carried in small "packages" known as "bad cholesterol,' or low-density lipoprotein (LDL) particles, the higher one's risk for a heart attack.
  • Cigarettes - Cigarette smoking not only damages the lungs, but makes an individual more susceptible to atherosclerosis.
  • Diabetes - People with diabetes have an accentuated risk for atherosclerosis.

Doctors have called these easily measured indexes "risk factors" because of their ability to predict future cardiovascular complications. Fortunately, the risk factors listed above can be avoided or modified. For example, one can stop smoking tobacco, treat high blood pressure, and manage diabetes. However, certain risk factors for atherosclerosis cannot be modified, including age, sex, and one's genetic makeup as reflected by a family history of atherosclerosis. The risk is particularly high for people whose close relatives, such as parents or siblings, developed atherosclerosis at a relatively young age. Men tend to develop atherosclerosis at younger ages than women, but after menopause women tend to quickly "catch up" with men. Indeed, atherosclerosis is a major cause of death and heart attack in women.

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Funding is provided by Medtronic, AstraZeneca, and Mars, Incorporated - makers of CocoaVia. Additional funding is provided by the Fannie E. Rippel Foundation. A co-production of David Grubin Productions, Thirteen/WNET New York and WETA Washington, D.C.
Medtronic AsrtaZeneca MARS Thirteen/WNET NEW YORK