Hardened Arteries (Atherosclerosis)

What is atherosclerosis?

Atherosclerosis is also known as hardening of the arteries. It occurs when plaques build up in the lining of the arteries (see diagram below). These plaques are made up of a number of substances, such as cholesterol and cellular waste products. They build up gradually over the years. However the rate at which they develop depends on a number of factors, such as a person’s genes, your cholesterol level, and whether or not you smoke.

Atherosclerosis usually affects the large arteries and the coronary arteries. The gradual build-up of atherosclerotic plaques over a long period of time can result in the arteries becoming narrowed, leading to poor circulation.

What does atherosclerosis do?

Atherosclerosis can occur in different parts of the body – its effects on your body will depend on the area of the body in which you have the problem. If the arteries that provide blood to your heart are affected (the coronary arteries), you may develop coronary artery disease. If the arteries supplying blood to the brain are affected, you may develop cerebrovascular disease (also known as stroke). If it’s arteries in your legs that are affected – or any other arteries in your body, then this is called peripheral vascular disease.

What happens in coronary artery disease?

Coronary artery disease is also known as coronary heart diseae – or just heart disease. It occurs when the coronary arteries are narrowed so much by atherosclerosis, that there isn’t enough blood and nutrients to supply the heart muscle.

What happens in cerebrovascular disease (stroke)?

If arteries in the brain are affected by atherosclerosis, clots can form, leading to the artery being blocked or ruptured (this is called cerebral haemorrhaging and leads to bleeding into the brain). Either of these cases will cause a stroke.

A stroke can cause a sudden onset of symptoms, which may include paralysis, speech difficulties, confusion and visual disturbances.

What happens in peripheral vascular disease?

Peripheral vascular disease is also sometimes called peripheral arterial disease, as it mainly just affects the arteries. In peripheral arterial disease, arteries that supply blood to the arms, legs or internal organs become blocked as a result of atherosclerosis.

Peripheral vascular disease most commonly affects the legs – the main symptom is cramping pains in the muscles of the legs on any exertion (this is called intermittent claudication).

If the blockage in the arteries becomes more severe, pain can occur even at rest. If the condition progresses without treatment, it can eventually lead to gangrene, necessitating amputation.

Unfortunately, having atherosclerosis in one area of the body (e.g., in the legs) is a sign that it may also be present elsewhere (e.g., the brain or heart). For this reason, people with peripheral vascular disease are at increased risk of heart attack and stroke.

What are the main risk factors for atherosclerosis?

One of the problems with atherosclerosis is that, in many cases, there are no symptoms until it is fairly advanced. For this reason you should be aware of the risk factors, particularly if this condition runs in your family.

What should I do if I have symptoms?

If you think you have symptoms associated with atherosclerosis, or you think you may be at risk, visit your family doctor (GP). Your doctor will be able to decide if you need further assessment. Early treatment can prevent diseases of the arteries from progressing.

The treatment you receive will depend on which form of the disease you have, but may include a combination of lifestyle changes and/or medication. Read the following articles for further information:

Reviewed: October 13, 2006