Atherosclerosis: The Silent Killer Atherosclerosis is one of a group of health problems that define coronary artery disease, oftentimes referred to as heart disease. Atherosclerosis is the leading cause of heart disease in the United States. The following is the definition provided by the American Heart Association: Atherosclerosis (at ” er-o-saleh-RO ” sis) comes from the Greek words at hero (meaning gruel or paste) and sclerosis (hardness).
It’s the name of the process in which deposits of fatty substances, cholesterol, cellular waste products, calcium and other substances build up in the inner lining of an artery. This buildup is called plaque. It usually affects large and medium-sized arteries.
Some hardening of arteries often occurs when people grow older (AHA, 2005).
Atherosclerosis is different from Arteriosclerosis, though the two are oftentimes concurrently present as a result of heart disease and are likewise confused. Arteriosclerosis is defined by the Well-Net group as: … during which the arteries of the cardiovascular system develop areas which become hard and brittle. Vessels become thickened. There is a loss of elasticity.
It can involve the arteries of the cardiovascular system, the brain, kidneys, upper and lower extremities. This occurs because of the deposition of calcium in their walls. Atherosclerosis often leads to coronary heart disease, strokes, and other disorders because of the occurrence of blood clots which form in the narrowed arteries; hardening of the arteries, on the other hand occur only in advanced stages (Lawrence, 1997).
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There are factors that can be controlled to aid in the prevention of atherosclerosis. The following research will address seven major “controllable” factors with special focus on how a person’s diet can help minimize the risk of developing this debilitating disease, or preventing a heart attack if the disease is already present.
According to The Cleveland Clinic Heart Center, “Coronary artery disease, also called coronary heart disease, or simply, heart disease, is the No. 1 killer in America, affecting more than 12 million Americans (Webmd. com, 2005).” Atherosclerosis occurs when the arteries that feed blood to the heart become narrowed due to the build up of plaque. This plaque is made up of fat, LDL cholesterol, calcium and other deposits. Plaque sticks to the walls of the coronary arteries where it eventually builds up and hardens, thus narrowing the passageways. Eventually this obstruction leads to the lack of blood and oxygen to the heart, which ultimately results in a heart attack (NHLBI.
There are eight major contributors that result in heart disease: heredity, smoking, high blood pressure, high blood cholesterol (LDL), physical inactivity, obesity, diabetes, and arterial inflammation. The remaining seven contributors can be controlled, or at least reduced to safer levels that will help prevent or even reverse the disease, prevent a heart attack, and prolong one’s life. Smoking Extensive clinical studies have proven that smoking is a major factor in the development and progression of arterial sclerosis. Additionally, the risk of heart disease is more than twice that of non-smokers.
According to the University of California at Berkeley, “Anywhere from 20 to 40% (100, 000 to 200, 000 every year) of all heart disease deaths in the U. S. are directly attributable to smoking. The American Heart Association reports an even gloomier number, “Cigarette smoking is the most important preventable cause of premature death in the United States. It accounts for more than 440, 000 of the more than 2. 4 million annual deaths.
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Cigarette smokers have a higher risk of developing a number of chronic disorders. (AHA, 2005).
Smoking more than doubles one’s chances of eventually having a heart attack and increases the chance of dying from it by 70%. Smoking is also the leading cause of sudden cardiac death. The good news is that by quitting smoking now, it will reduce the risk of developing heart disease. Within five to ten years of quitting, the risk of heart attack declines to a level similar to that of people who never smoked, regardless of how long one smoked (Berkeley Wellness.
How does smoking cause heart disease, or arteriosclerosis? Smoking causes heart disease by creating several dangerous conditions, both short term and long term: The role of smoking in Coronary Heart Disease: Inhaling tobacco smoke causes several immediate responses within the heart and its blood vessels. Within one minute of starting to smoke, the heart rate begins to rise: it may increase by as much as 30 percent during the first 10 minutes of smoking. Nicotine raises blood pressure: blood vessels constrict which forces the heart to work harder to deliver oxygen to the rest of the body. Meanwhile, carbon monoxide in tobacco smoke exerts a negative effect on the heart by reducing the blood’s ability to carry oxygen (ASH, 2004).
Smoking and arterial disease: Smoking tends to increase blood cholesterol levels.
Furthermore, the ratio of high-density lipoprotein cholesterol (the “good” cholesterol) to low-density lipoprotein cholesterol (the “bad” cholesterol) tends to be lower in smokers compared to non-smokers. Smoking also raises the levels of fibrinogen (a protein which causes blood to clot) and increases platelet production (also involved in the formation of blood clots) which makes the blood stickier. Carbon monoxide attaches itself to hemoglobin (the oxygen-carrying pigment in red blood cells) much more easily than oxygen does. This reduces the amount of oxygen available to the tissues. All these factors make smokers more at risk of developing various forms of atherosclerotic disease. As the atherosclerotic process progresses, blood flows less easily through rigid and narrowed arteries and the blood is more likely to form a thrombosis (clot).
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This sudden blockage of an artery may lead to a fatal heart attack, a stroke or gangrene of the leg (ASH, 2004).
By quitting smoking at anytime, the short-term effects reduce almost immediately. The long-term effects begin to reduce such that in a few years the former smoker may not have a risk for heart disease any greater than the population of those who never smoked. High Blood Pressure High blood pressure is another factor in heart disease. It has a number of causes, such as smoking mentioned above. However, other factors, including diet can also contribute to or cause high blood pressure.
High blood pressure, also known as hypertension, results from arterial narrowing which in turn causes blood to be pumped with greater force against the arterial walls. Hypertension can be corrected by changes in nutrition (for example, avoiding salt, increasing consumption of fruits, vegetables, and low-fat dairy products) and through the use of drug therapy which includes beta-blockers, ACE inhibitors, and calcium channel blockers (Imaginis. com, 2001).
The underlying problem with salt is the sodium, a light alkali metal and a strong oxidant. Everyone should limit their intake of sodium to less than 2, 400 mg per day (NHLBI 1999) but not lower than 500 mg per day according to the US Food and Drug Administration’s recommended daily allowance. Reduction and control of high blood pressure can also be controlled through aspirin therapy in which a daily dose of 81 mg strength aspirin is consumed; the aspirin acts as a blood thinner which helps those who have had heart attacks to mitigate its effects or prevent future heart attacks.
Thinning the blood also helps balance blood pressure (AHA 2005).
Cholesterol High blood cholesterol (LDL) is one of the primary causes of high blood pressure leading to heart disease and atherosclerosis. Average normal healthy levels of total cholesterol are less than 200 mg / d L (AHA 2005).
Low Density Lipoprotein (bad) should measure less than 100 to 129 mg / dl , and High Density Lipoprotein (good) should be at or higher than 40 mg / dl .
When these levels reach 240 mg / dl total cholesterol with and HDL less than 40, and LDL higher than 130 to 160 mg / dl , then one becomes a high risk for atherosclerosis and heart attack (AHA 2005).
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Even though cholesterol is an important component in the development of atherosclerosis, it can be controlled to an extent. The propensity to have high cholesterol is often due to heredity. However, diet and lifestyle choices such as smoking and other factors can also have a major influence on your chances of acquiring high cholesterol. The most common medications used today to help reduce LDL cholesterol and increase HDL cholesterol are called stations.
However, there are other, more natural ways to improve the LDL/HDL ratios such as through the dietary reduction of saturated fats and reduced intake of LDL Cholesterol. Fats and Oils Cheese, eggs, dark chicken or turkey meat and red meats are high in LDL cholesterol; by limiting the intake of these and other similar foods, you can substantially reduce and control your overall cholesterol. On the other hand, we can also increase our HDL levels by using good fats such as olive and canola oil and by eating certain vegetables, such as onions, that are high in HDL. Finally, fish oil high in long chain omega-3 fatty acids are among the best ways we can greatly increase HDL levels while lowering LDL levels. Omega-3 fatty acids have been clinically shown to reduce atherosclerosis (Sears, 2003) Often, cardiologists and family physicians will also recommend a high dose of fish oil to combat heart disease.
For example, 9 grams of long-chain omega-3 fatty acids (from fish oil) each day can significantly reduce high blood pressure (Sears, 2003) Exercise Lack of physical activity is another contributor to the development of heart disease. A program of moderate and regular exercise helps reduce body fat, tone muscles, and reduce high blood pressure. Johns Hopkins Bayview Medical Center had this to say about exercise: Exercise not only helps fight heart disease, but for sedentary people, just adding a little exercise to your daily routine reduces the risk of high blood pressure, osteoporosis, breast and colon cancer, depression, anxiety and stress. Ideally, you should exercise three to five times a week for 20-50 minutes within your target heart rate. The benefits of exercise to the heart are (JHBMC, 2005): o Improves heart and lungs o Decreases resting blood pressure o Decreases body fat o Decreases total and LDL cholesterol (‘bad cholesterol’) o Raises HDL cholesterol (‘good cholesterol’) o Increases energy level o Increases tolerance to stress and depression o Controls or prevents the development of diabetes o Decreases risk of orthopedic injury Exercise, therefore, is an essential component to be combined with proper nutrition, medication as needed, to assure a reduced risk of heart disease, or to help reverse the disease. Obesity is connected to a poor diet and lack of exercise, as well as heredity factors.
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For example, obesity causes the following according to the American heart Association (AHA, 2005): o raises blood cholesterol and triglyceride levels. o lowers HDL ‘good’ cholesterol. HDL cholesterol is linked with lower heart disease and stroke risk, so reducing it tends to raise the risk. o raises blood pressure levels. o can induce diabetes. In some people, diabetes makes these other risk factors much worse.
The danger of heart attack is especially high for these people. While proper diet and exercise are important in controlling or preventing obesity, a difficult problem arises for those who are already obese, and then develop heart disease and diabetes. It becomes even more vital to reduce body weight and lose excess fat, yet at the same time a lot of exercise is often not recommended. So a person who suffers from heart disease has a long slow road of painstaking effort to reduce weight and body fat. Obesity increases the strain on the heart, raises blood pressure and cholesterol and increase the risk of acquiring diabetes (Imaginis.
Even modest weight loss can increase one’s health and allow the body to perform without overexerting itself. Controlling one’s weight can be achieved through regular exercise and a healthier diet. Diabetes The development of diabetes is likelier if you already have a history of heart disease, or vice-versa.
If heart disease and high blood pressure go untreated, a person can develop diabetes. Diabetes further aggravates heart disease. If a person already has diabetes, they have a high risk factor for developing heart disease. The most common form of diabetes is Type II, which develops in adults.
It can be controlled by a diet lower in carbohydrates, primarily reduction of simple carbohydrates such as candy and refined processed foods like crackers and breads. However, Type II diabetes quite often has to be augmented by oral medication. The following connection between diabetes, diet, and heart disease was made on CNN: … cardiovascular disease is the most common – and most serious – complication of diabetes, increasing your risk of heart attack and stroke. In fact, about 65 percent of people with diabetes die of these two conditions (Mayo/CNN 2005).
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The same report described the mechanism of how diabetes affects the heart: Diabetes can damage your blood vessels, including the arteries that supply blood to your brain and heart.
This damage makes it easier for fatty deposits (plaques) to form in the arteries. The buildup of arterial plaques, a condition called atherosclerosis, can choke off blood supply and drive up your blood pressure (Mayo/CNN 2005).
Arterial Inflammation Arterial inflammation is another serious factor in heart attacks. Current medical thinking considers inflammation as possibly the most important factor leading to fatal attacks. The American Heart Association says the following about inflammation:” Inflammation” is the process by which the body responds to injury. Laboratory evidence and findings from clinical and population studies suggest that inflammation is important in atherosclerosis (at ” er-o-saleh-RO ” sis).
This is the process in which fatty deposits build up in the lining of arteries (AHA, 2005).
Further, there is a means to detect if inflammation is a risk factor: C-reactive protein (CRP) is one of the acute phase proteins that increase during systemic inflammation. It’s been suggested that testing CRP levels in the blood may be a new way to assess cardiovascular disease risk. A high sensitivity assay for CRP test (hs-CRP) is now widely available (AHA, 2005).
Inflammation is treated by various medications according to the type of inflammation and location in the body. Its role in heart disease is still being studied, and therefore medical treatment is in the early stages of research.
In addition to various medical treatments for inflammation, however, there are dietary and nutritional ways to help control inflammation: The foods we eat play an important roll in how we feel. Loading up on junk foods and fast foods tend to make us feel worse due to the unhealthy fats that are used in the cooking processes. Excessive consumption of sugars and refined starchy carbohydrates like white flour can make inflammation worse. Switch your diet to whole fruits, vegetables, and lots of cold water oily fish (Nutrition 2005).
The same article went on to address another important nutritional component to reducing inflammation: The right type of fats in our diets will impact pain and inflammation in a positive way.
Omega-3 oils that are found in cold water oily fish, walnuts, flax and pumpkin seeds will reduce inflammation. It may be beneficial to supplement the omega 3 oils with flax oil or fish oil capsules. Add some vitamin E as well (Nutrition 2005).
The recommendations are consistent with other published literature with respect to omega-3 fatty acids, as found in fish oil, to help control or prevent inflammation in the heart arteries (Sears, 2003).
Diet Given the considerations above of the major causes of atherosclerosis and heart disease, the following are good general recommendations for a heart healthy diet: According to the United States Department of Health and Human Services (Health. gov, 2005), A healthy eating plan is one that: o Emphasizes fruits, vegetables, whole grains, and fat-free or low-fat milk and milk products.
o Includes lean meats, poultry, fish, beans, eggs, and nuts. o Is low in saturated fats, trans fats, cholesterol, salt (sodium), and added sugars. It is also recommended that one follow a specific caloric diet (depending on personal nutritional needs which should be discussed with one’s physician).
Foods suggested to help achieve a proper nutritional balance of vitamins, minerals and anti-oxidants are fruits, vegetables, calcium and grains all of which should come from various sources and in different forms such as frozen, dried and fresh. Furthermore, if a person feels a need to have meats in his or her diet, choosing meats that are low in fats, such as fish and poultry, will help maintain healthy absorption and transmission of the proteins and will help reduce the risk of atherosclerosis.
Alternative choices to meats are beans, nuts and seeds (Health. gov, 2005).
Although there are many other controllable factors that may increase the risk of developing atherosclerosis, such as high cholesterol, diabetes, stress and alcohol consumption, there are also several factors that are not controllable such as age, gender, heredity and race. Fortunately, the continuous awareness of how one lives his or her life, what type of foods are eaten and how one exercises can drastically decrease the risk of acquiring coronary artery disease, specifically atherosclerosis. References About. Com (2005).
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