Arteriosclerosis, also called atherosclerosis occurs when there is a buildup of plaque around the artery wall causing the arteries to become narrow and hard. It is also called the hardening of the arteries. This can restrict blood flow to the tissues and organs.

The work of the arteries is to transport blood from the heart to the rest of the body. The endothelium (a thin layer of cells) forms a lining that keeps the arteries smooth allowing for easy blood flow. Atherosclerosis occurs when the endothelium is damaged due to factors such as hypertension, smoking, or high levels of fat, glucose, and cholesterol in the blood. This allows for plaque to build up in the wall of the arteries.

Pieces of plaque can also break off and cause a blood clot. Atherosclerosis can lead to a stroke, heart attack, or heart failure if left untreated.

Causes of Arteriosclerosis

Atherosclerosis is a slow progressing condition and the exact cause is not known but it may start from an injury or damage to the inner layer of the skin. This may be caused by:

• High cholesterol
• Hypertension
• Smoking
• High triglycerides which is a type of fat in the blood
• Diabetes
• Insulin resistance
• Obesity
• Inflammation from conditions such as arthritis, infections, or lupus
• Aging
• Poor diet

When the inner wall of the artery is damaged, substances including blood cells clamp and build up at the site of the injury in the inner lining of the artery. Over time, plaque and other cellular products also build up at the site of the injury and harden thus narrowing the arteries. This limits the blood supply to the tissues and organs that are connected to the blocked arteries.

Symptoms of Arteriosclerosis

Symptoms of arteriosclerosis tend to develop gradually and most of them do not show up until an artery is blocked. Although arteriosclerosis mostly affects older people, it can start developing in adolescence.

The symptoms present usually depend on the type of arteries affected.

• Carotid arteries: These supply blood to the brain and restricting their blood flow can lead to a stroke whose symptoms include weakness, headache, facial numbness, difficulty breathing, and paralysis.
• Coronary arteries: They supply blood to the heart and if this fails it can cause a heart attack or angina. The symptoms include vomiting, chest pain, fainting, coughing, and extreme anxiety.
• Renal arteries: They supply blood to the kidneys and if this is limited it lead to chronic kidney disease. The symptoms include loss of appetite, difficulty concentrating, and swelling of the hands and feet.
• Peripheral arteries: These arteries supply blood to the arms, pelvis, and legs. If their blood supply is limited, an individual my experience pain and numbness in their limbs. In severe cases, gangrene and tissue death can occur.

Diagnosis of Arteriosclerosis

Diagnosing arteriosclerosis involves a physical exam to check for a weakened pulse, an aneurysm, or slow wound healing which may be an indication of restricted blood flow.

A doctor may also listen to your heart to check for abnormal sounds and more tests may be ordered if atherosclerosis is suspected.

The tests include:

• Blood test: To check the cholesterol levels
• Doppler ultrasound: This can show blockage in the arteries using sound waves to create a picture.
• Ankle-brachial index (ABI): This can detect blockage in the limbs by comparing the blood pressure in each limb.
• Cardiac angiogram: This is a chest x-ray taken after the heart arteries have been injected with a radioactive dye.
• Magnetic resonance angiography (MRA): Creates pictures of the large arteries in the body.
• Electrocardiogram (ECG or EKG): Measures electrical activity in the heart to look for any areas of limited blood flow.
• Stress test: Monitors the heart rate or blood pressure as an individual exercises on a stationary bicycle or treadmill.

Treatment of Arteriosclerosis

Receiving early treatment for arteriosclerosis can help in reducing the risks of severe complications.

The goal of the treatment is to stop or slow down the development of plaque, prevent blood clots from forming, and treat symptoms.

The treatment options include:

• Lifestyle changes: These include:
• Regular exercising
• Healthy diet
• Avoid smoking
• Maintain healthy weight
• Consume alcohol in moderation
• Medication: These prevent the symptoms from worsening, and they include:
• Statins or fibrates – cholesterol-lowering medication
• Beta-blockers to lower the blood pressure
• Angiotensin converting enzyme (ACE) inhibitors to help prevent narrowing of the arteries
• Diuretics to help lower the blood pressure
• Anticoagulants to prevent blood from clotting and clogging the arteries
• Surgery may sometimes be needed to ensure effective blood flow in the arteries. The surgical options include:
• Bypass surgery to transport blood around the affected area
• Using a stent to widen the artery
• Surgery to remove the plaque build up

Next Step

At King’s College Hospital Dubai, we focus on offering an exemplary service. From initial consultation through to final diagnosis, treatment and beyond. Our multidisciplinary team of expert doctors, nurses, cardiologists and technologists are here to offer tailored management and treatment of your condition, and to answer any questions that you may have throughout your time with us. Whatever you need us for, we’re only a phone-call away.