Arteriosclerosis and atherosclerosis

Arteriosclerosis is a condition that occurs when arteries narrow and harden, weakening them to the point that they can no longer effectively serve their core function: circulating blood throughout your body. This narrowing of the arteries can hinder blood from traveling to your organs.

Atherosclerosis is the buildup of fat, cholesterol and other substances on your artery walls. Atherosclerosis is a specific kind of arteriosclerosis, but these terms are often used interchangeably.

Our vascular specialists believe in a conservative, or noninvasive first approach to treatment. We may suggest medication coupled with healthy lifestyle adjustments, such as a healthy exercise plan. Your quality of life also drives the recommendations we make for your care. If atherosclerosis is limiting your lifestyle, a minimally or open surgical approach may be warranted, particularly if those limitations are also putting your limbs, or life at risk. If you’re at high risk for, or have already developed gangrene, we will take a more aggressive approach. We consider what is best for your unique situation.

Typically, there are no symptoms associated with atherosclerosis, unless plaque ruptures and travels through the bloodstream. The symptoms you experience are dependent upon the location where the buildup originated. The symptoms might include:

• In the legs and feet: weakness, numbness, claudication (pain when walking), rest pain, gangrene
• Near the heart: chest pain or tightness, coughing, vomiting, heart attack

Since atherosclerosis most often has no symptoms, it’s important to see a doctor if you do experience symptoms, as this usually indicates the presence of a more serious condition, or even a medical emergency. If left untreated, atherosclerosis could lead to coronary artery disease, carotid artery disease or peripheral artery disease, all of which may produce life-threatening complications.

Diabetes and smoking are the two largest risk factors for developing atherosclerosis. You could also be at risk for developing this condition if you have high blood pressure or high cholesterol. Genetics also play a factor, so it’s important to talk to your doctor about your family history. Since atherosclerosis is a condition that gradually progresses, the risk of developing it increases with age. Most cases occur in individuals who are middle-aged or older.

Sometimes, medications are prescribed to address the risk factors contributing to your condition. For instance, if cholesterol is the culprit, we might prescribe a statin to reduce fats in the blood. Blood thinners may also be prescribed in some instances. As with any medication, these carry their own potential for side effects, which are always discussed in depth prior to administration.

Both arteriosclerosis and atherosclerosis are very common, though pinpointing how much of the population is affected by either condition is difficult since most cases are asymptomatic. 

Complications related to atherosclerosis are dependent on where it exists within the body. A rupture of plaque buildup can cause detrimental effects to surrounding areas and organs. Buildup originating in the lower extremities could lead to gangrene if plaque cuts off blood supply. Similarly, a rupture located in the coronary arteries could lead to a heart attack, while those in the carotid and renal arteries could lead to a stroke and chronic kidney disease, respectively.

Sometimes, medications are prescribed to address the risk factors contributing to your condition. For instance, if cholesterol is the culprit, we might prescribe a statin to reduce fats in the blood. Blood thinners may also be prescribed in some instances. As with any medication, these carry their own potential for side effects, which are always discussed in depth prior to administration.

Early diagnosis is the key to avoiding dangerous complications. If you identify any of the symptoms described above and/or have a family history of atherosclerosis, it’s important to ask your doctor to test for the condition. The test we perform will depend on the location we believe atherosclerosis could be present. For instance, if your symptoms indicate you may have atherosclerosis in the lower extremities, we would likely perform an ankle brachial index test, which involves cuffing the arms and ankles while we use ultrasound to measure blood flow and pressure; it’s basically a blood pressure monitor for your legs.

Usually, we take a conservative approach to treatment, focusing more on lifestyle changes and management of risk factors. You may also be prescribed medication to control your cholesterol and platelet function. In certain cases, surgical intervention is necessary. Surgical options include:

• Angioplasty and stenting
• Bypass grafting
• Endarterectomy
• Vertebral artery reconstruction

The recovery process varies from treatment to treatment. If the status of your condition warrants surgical intervention, your doctor will thoroughly cover all details regarding the recovery process.

Prevention is paramount for atherosclerosis. Lifestyle adjustments, such as quitting smoking, having a healthy diet with limited saturated fats, exercising regularly, and maintaining strict blood sugar control can make all the difference.