Arteriosclerosis

Arteriosclerosis is a broad term for several different vascular disorders. These conditions involve the abnormal thickening and hardening of arterial walls. As the arteries harden, they also lose their natural elasticity. This loss of flexibility can gradually restrict blood flow to various organs and tissues. One specific and dangerous form of this condition is called atherosclerosis. Atherosclerosis occurs when fatty plaques build up inside the arterial walls. This buildup can lead to serious health risks like strokes or coronary artery disease.

The disease process follows a specific biological path. It often begins within the intima, which is the innermost layer of the blood vessel wall. During this stage, cellular wastes begin to deposit and fill this inner layer. As these deposits grow, they cause the vessel walls to stiffen and thicken. This is a degenerative disease, meaning it changes the structure of the vessels over time. The specific way the artery changes depends on which substances are depositing.

Scientists identify several distinct types of arteriosclerosis based on how they affect the body. Arteriolosclerosis is a type that only affects small arteries and arterioles. These tiny vessels are responsible for carrying nutrients and blood to individual cells. In contrast, atherosclerosis affects large and medium-sized arteries. The plaque in atherosclerosis is composed of cholesterol, fatty substances, and cellular waste. It can also contain calcium and fibrin. Another type is Monckeberg's arteriosclerosis, or medial calcific sclerosis. This type is most commonly seen in elderly people and often affects the arteries in the extremities.

There are also specific classifications for how lesions appear in the vessels. Hyperplastic arteriosclerosis is a type that impacts large and medium-sized arteries. Another form is known as hyaline arteriosclerosis, or arterial hyalinosis. This occurs when homogenous hyaline deposits in the small arteries and arterioles. These different types all share the common feature of vessel stiffening. Because the types vary, the symptoms a person feels will also vary.

Symptoms depend entirely on which blood vessels are being affected by the disease. If the disease impacts the cerebral or ophthalmic vessels, it can cause a stroke. This might result in sudden weakness, confusion, or difficulty understanding speech. A person might also experience facial numbness or problems with their vision. If the coronary vessels are affected, it leads to coronary artery disease. This often presents as chest pain.

History shows that the clinical implications of this disease were not fully understood until the 20th century. While many cases were recorded earlier, the science caught up much later. A person named Jean Lobstein actually coined the term arteriosclerosis. He developed the name while he was analyzing the composition of calcified arterial lesions. The name itself comes from two Greek words. The word "artēría" means artery, and "sklērōtikós" means hardened.

The impact of these diseases on public health is very large. In 2008, the United States had an estimated 16 million cases of atherosclerotic heart disease. During that same year, there were 5.8 million strokes recorded. Cardiovascular diseases caused by arteriosclerosis led to almost 812,000 deaths in 2008. This number was higher than deaths from any other cause, including cancer. Currently, about 1.2 million Americans are predicted to suffer a heart attack every year.

Doctors use several methods to diagnose and treat these conditions. A diagnosis might involve a physical exam, blood tests, or an EKG.

Treatment often focuses on prevention through lifestyle changes like exercise or stopping smoking. Medical therapies include statins for cholesterol or ACE inhibitors for high blood pressure.

If surgery is needed, doctors can perform an angioplasty. This uses a balloon to push plaque against the walls and a mesh tube to keep the artery open. Other options include coronary artery bypass surgery or an endarterectomy to remove plaque. Finally, thrombolytic therapy can use medicine to break up plaque masses.