Vascular atherosclerosis: first manifestations, symptoms and treatment. Why is atherosclerosis dangerous?
The essence of atherosclerosis is that inner surface arteries (which in a healthy state are even and smooth), growths appear - cholesterol deposits. They harden and affect the inner walls of the vessel. These growths (“cholesterol atherosclerotic plaques”) are covered with connective tissue and protrude into the cavity blood vessel and narrow the lumen of the vessel, reduce its diameter and impede blood circulation. Internal organs suffering from lack of nutrition cease to function fully. The risk of thrombosis and stroke increases.
Forms and symptoms of vascular atherosclerosis
Symptoms of atherosclerosis depend on the location of the disease.
- Atherosclerosis of cerebral vessels. They often say “cerebral atherosclerosis of cerebral vessels.” In this case, the arteries of the brain are affected by cholesterol plaques located in large and medium-sized vessels. Symptoms: memory loss, concentration, decreased mental activity, dizziness, headaches. Symptoms of cerebral atherosclerosis of the cerebral vessels are often associated with typical signs of aging.
- Atherosclrosis carotid arteries (carotid atherosclerosis) is a disease characterized by damage to the carotid arteries. The carotid arteries are the most important conductors of oxygen for the brain. Speech abilities, thinking, sensations and motor activity. When the carotid arteries are damaged, the full functioning of the brain and the entire body is disrupted.
- Atherosclerosis of the coronary vessels. There is a disturbance in the blood supply to the tissues of the heart, externally this manifests itself as attacks of angina, cardiosclerosis, cardiac arrhythmia, myocardial infarction.
- Atherosclerosis of the thoracic aorta. Symptoms: increased systolic blood pressure, dizziness, hoarseness, difficulty swallowing, prolonged pressing or burning pain in the chest.
- Atherosclerosis of the lower extremities. On initial stages diseases symptoms of atherosclerosis of the lower extremities include fatigue and pain in calf muscles, chilliness in the legs, cramps, pale skin of the legs.
- Obliterating atherosclerosis of the vessels of the lower extremities, is one of the forms of atherosclerosis of the legs. In this disease, cholesterol plaques form on the walls of the arteries and interfere with normal blood flow, causing narrowing of the blood vessels (stenosis) or complete blockage, called occlusion or obliteration, therefore they talk about occlusive-stenotic damage to the arteries of the legs. IN advanced stage obliterating atherosclerosis of the vessels of the lower extremities, an irreversible process of necrosis occurs - gangrene of the leg (death of all tissues below the site of blockage of the artery).
Complications resulting from atherosclerosis
As a result of atherosclerosis, it often occurs development of a chronic autoimmune process in atherosclerotic plaques. The connective tissue grows and this leads to slow deformation and narrowing of the lumens, thereby causing a chronic, slowly increasing insufficiency of blood supply to the organ that is fed through the affected artery. It is also possible that the lumen may be blocked by a blood clot or the contents of an atherosclerotic plaque that has disintegrated. The result of such thrombosis can be a heart attack (necrosis) or gangrene in the organ that is supplied by the artery.
As a result of cerebral atherosclerosis, ischemic or hemorrhagic stroke, - both conditions are life-threatening.
Myocardial infarction (a consequence of atherosclerosis of the coronary vessels) is one of the most common causes of death.
Prevention of atherosclerosis
Prevention of atherosclerosis includes quitting smoking, weight regulation, limiting emotional overload, certain dietary restrictions, increasing physical activity.
To maintain the body and prevent atherosclerosis, you should eat foods low in salt, sugar and cholesterol. A low-calorie, low-fat diet is recommended. It is necessary to eat grains, vegetables, herbs, red wine, unrefined vegetable oil.
Treatment of vascular atherosclerosis
Treatment of atherosclerosis can be medicinal and surgical.
Treatment of cerebral atherosclerosis is, of course, medication. Prescribed drugs that:
- dilate blood vessels in the brain;
- strengthen the elasticity of the vascular wall;
- improve metabolism cellular level brain;
- lower the level of cholesterol in blood vessels;
- relieve vascular spasms.
In the treatment of atherosclerosis of the vessels of the lower extremities, in addition to taking medications, physiotherapeutic treatment is also used: darsonvalization, electrophoresis with novocaine, hyperbaric oxygenation. In the presence of trophic ulcers, antibiotic ointments are used.
In the treatment of atherosclerosis of the vessels of the lower extremities, surgical intervention is also allowed, but usually this is a last resort. Surgery prescribed for severe ischemia and the occurrence of very severe complications.
The need and extent of surgical intervention is determined by the surgeon. Surgical treatment of atherosclerosis does not provide complete cure. The complication is eliminated, not the cause that caused it (atherosclerosis). Therefore, after surgery, changes in lifestyle, nutrition and conservative treatment are required.
- treatment of pathologies that aggravate atherosclerosis (for example, diabetes mellitus, hypertension, etc.),
- smoking cessation,
- low diet cholesterol content,
- moderate physical activity,
- in case of atherosclerosis of the vessels of the legs - wearing comfortable shoes.
First, let's look at what atherosclerosis is. IN modern medicine atherosclerosis is a chronic disease of various human organs, caused by the accumulation of so-called bad cholesterol on the inner walls with other types of plaque in the form of plaques and subsequent narrowing of the lumen. Because of this, blood flow is disrupted, blood vessels narrow, and organs experience a lack of blood. Sometimes the vessels become completely blocked, and there is a risk of developing severe cardiovascular pathologies.
Atherosclerosis detected at an early stage is treatable.Atherosclerosis is considered a pathology of increased danger, since it can lead to fatal outcome. The disease can be recognized mainly when there are problems with altered blood supply to human organs and limbs, that is, atherosclerosis is diagnosed in patients in the last stages of its development. Initially, atherosclerosis was considered a disease of old age, since the risk of its development gradually increased in proportion to a person’s age. But recent data indicate an increase in the percentage of young people experiencing this pathology. Atherosclerosis has an ICD 10 code I70.
Symptoms
It is important to recognize the signs of atherosclerosis in time to begin timely treatment. But the symptoms of this disease do not always appear, or they are subtle. This complicates timely diagnosis. Atherosclerosis is considered a systemic disease, therefore it affects large areas circulatory system person. This explains the variety of manifestations of the disease. This pathology mainly affects the brain, human limbs and.
Specific symptoms are characteristic of the disease, but it is not always possible to detect it on time and correctly. For some people, the symptoms are very mild, and they attribute the malaise to physical or emotional fatigue, the consequences of sports and other factors.
Manifestations are directly related to which organ is affected by the disease. But all are characterized by preclinical and clinical symptoms. In the first case, there are no signs, since the process is just developing. When the lumen closes by 50%, pronounced negative signs begin to appear. Most patients already seek help with them. The doctor, after conducting a comprehensive diagnosis, determines how to treat atherosclerosis in each specific case. How the disease manifests itself depends on the organ affected. Mainly the heart, limbs and brain.
Damage to the heart muscle
In approximately 75% of cases with atherosclerosis, symptoms actively manifest themselves in the form of unpleasant and pronounced pain in the area of the heart. The disease affects the coronary vessels, affecting the decrease in oxygen flow and intake nutrients to this body. The heart is considered the most sensitive organ to changes in the quality of its nutrition. Second only to the brain. The main symptoms include:
- pain in the chest area;
- feeling of chest tightness;
- impaired breathing;
- pain when inhaling and exhaling;
- attack-type angina;
- instability of the patient's blood pressure;
- back pain;
- pain radiating to the jaw, ear or neck;
- feeling cold;
- weakness in the limbs;
- attacks of vomiting and nausea.
The intensity of manifestations depends on the stage of atherosclerosis. The more advanced the disease, the more pronounced the symptoms will appear. Stress, bad habits and overeating aggravate the disease.
Manifested when the vessels of the upper or lower extremities are damaged:
- feeling cold;
- feeling of goosebumps running over the skin;
- the skin becomes pale.
If complications of atherosclerosis are observed and the disease is in an advanced stage, then the symptoms become brighter. This manifests itself in the following:
- the process of tissue degeneration begins due to nutritional deficiency;
- the fat layer becomes thinner;
- hair falls out (this process is irreversible);
- observed severe pain in the arms or legs;
- wounds appear on the limbs;
- affected areas of the body swell;
- fingers and toes turn red;
- the process of tissue necrosis begins.
Severe phases of atherosclerosis of the extremities require surgical intervention.
Brain damage
People with atherosclerotic syndrome face the most striking manifestations of pathology. This is due hypersensitivity organ. The following symptoms present as vascular disease progresses:
- a headache occurs, but without a clear localization, therefore it is impossible to detect the exact area of these painful sensations;
- there is ringing and noise in the ears;
- a person’s sleep is disturbed (he may suffer from insomnia or constantly want to sleep);
- often have nightmares, which is due to brain activity and oxygen deficiency;
- the personality changes for the worse (the person becomes irritable, nervous, aggressive);
- a person becomes overly excitable, nervous, and is constantly accompanied by a feeling of anxiety;
- the disease is accompanied by lethargy and increased fatigue with minimal physical activity;
- key functions such as speech, breathing and the ability to eat are gradually impaired;
- the quality of coordination changes, it becomes difficult for a person to move and navigate independently.
One can only imagine what the feelings of a person faced with similar disease. He ceases to control his own body, which causes panic attacks, psycho-emotional disorders, and a feeling of doom. This negatively affects the general condition. Therefore, it is important to identify the causes of atherosclerosis in a timely manner, prescribe a comprehensive diagnosis and begin treatment.
Causes of vascular disease
Knowing possible reasons development of the disease, you can try to prevent its manifestation by eliminating provoking factors. Vascular pathology develops when:
- smoking;
- chronic high blood pressure;
- diabetes mellitus;
- elevated cholesterol levels.
But doctors say that main reason serves to disrupt the proper metabolism of cholesterol in the patient’s body. Atherosclerosis forms naturally. The process begins at age 10 or older. As a person ages, processes may slow down or speed up. It all depends on the intensity of exposure to provoking factors.
There are several main factors that increase the likelihood of developing atherosclerosis and its active manifestation.
Knowing what can trigger the pathology, you have every chance to prevent this disease. Check your body carefully, watch what you eat and what you do.
Stages
Doctors cannot accurately name the reasons for the development of atherosclerosis. But it is reliably known that the basis of the mechanism is a violation of lipid metabolism. The manifestation of such dysfunction starts a process that leads to life-threatening atherosclerosis and other associated diseases.
The formation of the disease is conventionally divided into three stages.
- Formation of spots. These are fatty or lipid stains. At the first stage, there are no symptoms, the patient does not even know about the start pathological process in the body. Spots form quickly. If a sick person has diabetes mellitus, different stages obesity or cardiovascular diseases the process speeds up.
- Formation of the resulting layers. The tissue under the adhered lipid layer becomes inflamed. This is defensive reaction body. Because of this, it is formed chronic lesion inflammation. The process entails the decomposition of fatty deposits and tissue germination. As a result, lipids begin to rise above the vascular walls.
- Complications. This is the last stage of the development of the disease. A person faces complications, symptoms begin to manifest themselves clearly. The further process can follow two scenarios. Plaques rupture and lead to the release of blood and the formation of blood clots, or these plaques completely block the lumens of blood vessels. In the second case, there is a risk of stroke.
It is difficult to say exactly how long and how quickly the disease will develop. For some patients this takes a few weeks, for others it continues for several years. This largely depends on the specific metabolism, quality metabolic processes, predisposition and other factors.
Doctors
Based on which human vessels are affected by atherosclerosis, the disease is classified into several types. The disease may affect:
- aorta;
- coronary arteries;
- vessels supplying the brain;
- vessels of the extremities (lower and upper);
- renal.
And here a natural question arises about which doctor treats atherosclerosis. You need to push off from the affected area. If this disease is associated with the brain, then you need to go to a neurologist. If you have problems with the cardiovascular system, look for a cardiologist's office. And if it is the lower or upper extremities, you will need a phlebologist.
But usually you have to visit several doctors at once. If you don't know who to contact immediately upon arriving at the hospital, go to a therapist. He will give the necessary recommendations and referrals to the appropriate offices. Atherosclerosis needs comprehensive examination to identify all potential foci of development of this pathology. Do not start treatment on your own without prior consultation. Only based on the results of the examination and tests can an accurate diagnosis be made and complex therapy begin.
Diagnostic methods
Diagnosis of atherosclerosis in severe stages does not cause problems for doctors, since the disease manifests itself clearly and characteristically. But identifying violations at an early stage is difficult. To do this, the patient himself must think about his health and undergo preventive examinations. But even in this case only qualified specialist will be able to notice early signs atherosclerosis. Therefore, when diagnosing they use integrated approach. It includes a number of survey activities. The disease is confirmed using:
- collecting anamnesis of the patient seeking help;
- methods of initial examination (examination of the body, weighing, checking heart murmurs, pressure, etc.);
- laboratory examination methods;
- instrumental studies of the body.
An initial visit to the doctor will provide the necessary answers. The doctor will tell you how to check blood vessels for atherosclerosis and give appropriate directions to diagnostic rooms. If the diagnosis of atherosclerosis shows the presence of pathology, treatment will need to be promptly started. This requires time and effort. Terms of service in many public clinics and people’s lack of free time often become reasons for self-medication and ignoring the recommendations of preventive examinations. This is a global problem that needs to be addressed.
Treatment
With atherosclerosis, symptoms appear quite clearly only in the last stages of development. It is not so often that people detect pathology in the initial stages, which is explained by the asymptomatic nature of the disease. But if during the examination it was possible to identify disturbances in the functioning of blood vessels, the attending physician will immediately prescribe the necessary treatment. Otherwise, the consequences of atherosclerosis can lead to serious illnesses and even death.
Treatment is carried out using several methods, depending on current state patient and neglect of vascular disease.
- Drug treatment. Most cases of atherosclerosis can be eliminated by prescribing medications to patients. The list of medications includes statins, fibrates, nicotinic acid agents and sequestrant drugs. They are accepted as a whole. In order for the drugs to have the desired effect, in parallel, the patient must adhere to the rules of a healthy diet, maintain an optimal level of physical activity and lead a balanced lifestyle. Physiotherapy methods can complement treatment. They are relevant for those who are faced with vascular damage to the upper or lower extremities.
- Surgical intervention. For atherosclerosis, it is important to use three main surgical invasive methods. Bypass surgery and vascular prosthetics are considered highly invasive operations. With the help of bypass surgery, it is possible to create a new highway by connecting the affected vessels to healthy ones. Prosthetics of the affected areas allows you to replace the vessel using a unique modern material. There is also a minimally invasive method called angioplasty. It is based on inserting a catheter through the femoral artery and then clearing the blocked vessel.
An operation may be prescribed in advanced cases or when they are not given desired effect. You should not immediately resort to bypass surgery, prosthetics or angioplasty. If possible and time, it is better to use drug therapy. Modern drugs have high impact rates with minor side effects.
But the most reliable way to treat and protect against atherosclerosis in a person of any gender and age is prevention possible development of this disease.
Treatment is difficult and time-consuming, plus medications are expensive. By taking preventative measures, it is possible to maintain optimal health and prevent the development of complications. Be healthy, exercise, eat right and get rid of bad habits. So the likelihood of encountering atherosclerosis will be minimal. Subscribe to our website, share links with your friends, leave comments and ask current issues!
The site provides reference information. Adequate diagnosis and treatment of the disease is possible under the supervision of a conscientious doctor. Any medications have contraindications. Consultation with a specialist is required, as well as detailed study of the instructions!
Stenosing atherosclerosis is usually widespread, that is, it affects many vessels simultaneously, and therefore manifests itself in a variety of clinical symptoms. This type of atherosclerosis is almost impossible to completely cure; you can only stop the process and restore lost vascular patency.
Symptoms of stenosing atherosclerosis:
1. Brain symptoms:
- severe headaches that do not go away after taking it medicines and after sleep;
- weakness, malaise, sleep disturbance, inattention, impaired concentration, memory deterioration, gradually reaching partial loss, and so on;
- decreased vision, up to its loss;
- slurred speech, in severe cases – skewed facial expressions;
- decreased skin sensitivity, paresis of the limbs (paralysis).
3. Kidney symptoms characterized by increased blood pressure and the development of arterial hypertension.
4. Intestinal symptoms:
- intestinal gangrene (death of tissue gastrointestinal tract) – occurs when the blood circulation of the mesenteric vessels is completely disrupted.
Obliterating atherosclerosis of the lower extremities, what is it, what are the symptoms and prognosis?
Stenosing atherosclerosis of the lower extremities is called obliterating atherosclerosis of the vessels of the lower extremities(obliteration - complete closure of the lumen of a blood vessel). Gradually, from a vessel affected by atherosclerosis, anastomoses
– additional more small vessels, which partially restore blood circulation in “oxygen-starved” tissues, which is a compensation mechanism. When the compensatory mechanisms end, a complete cessation of blood circulation occurs in a certain area of the lower extremities, as a result - an extreme degree of obliterating atherosclerosis - gangrene, in which it is very difficult to save the limb. Therefore, it is extremely important to identify atherosclerosis of the vessels of the extremities in the early stages, because with the help of medication and/or surgical treatment the development of gangrene can be prevented.
Symptoms of obliterating atherosclerosis of the lower extremities:
Sections of the aorta:
- ascending aorta;
- aortic arch;
- descending aorta (divided into thoracic and abdominal parts);
- Aortic bifurcation is the place where the vessel bifurcates into two iliac arteries that supply the lower extremities.
Any part of the aorta can be affected, and depending on the location, certain symptoms occur.
Symptoms of atherosclerosis of the ascending aorta, arch and thoracic descending aorta:
- pain in the heart paroxysmal compressive nature, as with angina pectoris, pain can radiate to the arms, neck, stomach, back;
- pulsation of visible vessels between the ribs;
- increased blood pressure due to systolic (upper);
- dizziness and fainting;
- hoarseness of voice, impaired swallowing (with atherosclerosis of the aortic arch);
- rarely convulsive syndrome.
- periodic abdominal pain;
- bowel dysfunction - constipation;
- indigestion : heartburn, nausea, heaviness in the stomach after eating;
- weight loss.
Symptoms of atherosclerosis of the aortic bifurcation:
Aortic aneurysm– this is a protrusion of the vascular wall in a place above the area of the vessel blocked by an atherosclerotic plaque.
When blood flow through the aorta is obstructed, a large volume of blood is retained and stretches the vessel wall (containing a large amount smooth muscle). In this case, over time, the elasticity of the stretched wall is lost and the aortic aneurysm ruptures. Mortality from this complication very high, it is possible to help a person only with emergency surgery.
Symptoms of a ruptured aortic aneurysm:
- sharp acute pain in the chest or abdomen;
- a sharp decrease in blood pressure;
- shock, coma, if emergency assistance is not provided, death of the patient in a short time.
- diagnosis of atherosclerosis;
- computed tomography of the chest or abdomen;
- Ultrasound of the abdominal cavity.
Treatment of aortic atherosclerosis. The principles of treatment of aortic atherosclerosis are the same as for other atherosclerotic manifestations(diet, statins, anticoagulants, etc.). In the presence of an aortic aneurysm in the phase of dissection of the vascular wall (precedes the rupture of the aneurysm) or rupture, resort to to surgical treatment methods:
- remove the affected area of the aorta and replace it with an artificial vessel, or transplant their own vessels from healthy areas (bypass surgery);
- they apply special tissue to the area of the aneurysm, which prevents its rupture - the operation eliminates the life-threatening condition, but does not radically solve the problem (palliative surgery).
Atherosclerosis in diabetes, why does it occur and how does it manifest?
Diabetes mellitus puts a person at risk for the development of atherosclerosis. Diabetics are 5 times more likely to suffer from this vascular pathology, both young and old patients. And the mortality rate in this group of patients from complications of atherosclerosis is twice as high as in non-diabetics.
The course of atherosclerosis against the background of diabetes mellitus is more aggressive, severe, with frequent complications and the speed of the process.
For diabetes Absolutely all types of vessels can be affected, but most often it is observed atherosclerosis of such vessels:
- coronary;
- renal;
- cerebral vessels;
- fundus vessels;
- arteries and capillaries of the lower extremities.
The effect of diabetes mellitus on the risk of developing atherosclerosis:
1.
Poor nutrition. People suffering from type 2 diabetes mellitus often eat poorly; their diet includes large amounts of fat, which in itself increases the risk of developing atherosclerosis.
2.
Dysregulation of fat metabolism. In diabetes mellitus there is high level blood lipoproteins (beta fraction), the synthesis of phospholipids (“healthy” fats) is impaired, and dysfunction of the liver and pancreas, involved in lipid metabolism, develops.
3.
Malnutrition of the vascular wall against the background of diabetes mellitus, it helps to increase vascular permeability and cholesterol sedimentation.
4.
Violation of oxidation processes in the form of ketoacidosis, they promote the deposition of cholesterol plaques and the formation of connective tissue and calcium salts in it.
5.
Bleeding disorder and increased formation of blood clots lead to clogging of vessels affected by atherosclerosis.
6.
Specific vascular lesions for diabetes mellitus - diabetic angiopathy
are also directly related to atherosclerosis.
7.
High risk of developing arterial hypertension in diabetics and other diseases of the cardiovascular system, which is the main risk factor for the development of atherosclerosis.
Symptoms of atherosclerosis against the background of diabetes mellitus are the same as in non-diabetics, only more pronounced and rapidly developing.
Complications of atherosclerosis in diabetes:
- aneurysms of the aorta and other vessels, their ruptures;
- organ ischemia;
- coronary heart disease and myocardial infarction;
- diabetic encephalopathy, leading to strokes;
- nephropathy and, as a result, chronic renal failure;
- angiopathy of the fundus vessels leads to retinal detachment and blindness;
- Damage to the lower extremities over time leads to long-term non-healing trophic ulcers(diabetic foot) and gangrene, which often requires leg amputation.
Photo: diabetic foot.
Principles of treatment of atherosclerosis in diabetes mellitus:
- diet and insulin therapy, monitoring blood glucose levels;
- healthy image life, giving up bad habits;
- blood pressure control, treatment of arterial hypertension;
- proper care behind the legs;
- taking medications that lower cholesterol levels, nicotinic acid and others medications for the treatment of atherosclerosis;
- if necessary and possible, surgical methods of treating atherosclerosis.
- control over blood sugar levels, regular and controlled intake of insulin injections;
- proper nutrition, associated not only with controlling the carbohydrates eaten, but also fats;
- physical activity (but not heavy physical activity);
- quit smoking, do not abuse alcohol;
- regular monitoring of lipid profile;
- blood pressure control, ECG and so on.
Cholesterol in atherosclerosis, myths and truth
As you already understand, the main cause of atherosclerosis is increased level fats and cholesterol in the blood, and the condition of the vascular wall. They talk a lot about complete refusal from cholesterol. Does eliminating cholesterol from the diet really have a positive effect on atherosclerosis and the body as a whole, and is cholesterol itself almost a poison for the body? Let's try to figure this out.
Cholesterol (cholesterol) is a fat molecule that enters our body with food or is synthesized by the liver from other types of fats. If, with a lack of cholesterol, the body begins to produce it itself, then a person needs it.
Why do we need cholesterol?
- bile components (bile acids) are synthesized from it;
- cholesterol is a building block for the structure of the cell wall of all types of cells, ensures cell permeability for nutrients, ions and other components;
- participates in the absorption of vitamin D, necessary for bone growth and strength, as well as many other vitamins;
- Some hormones are synthesized from it (sex hormones, adrenal hormones - glucocorticosteroids, and so on).
As we see, many vital processes cannot take place without cholesterol: digestion, the structure of new cells, including immune cells, work endocrine system, reproductive processes, etc. So cholesterol is not poison and is not only not dangerous for us, but also very useful. Complete exclusion of cholesterol and other fats from the diet may cure atherosclerosis, but it will also significantly harm the body as a whole. Cholesterol can be beneficial and harmful. Good cholesterol is found in high density lipoproteins (HDL), but bad, promoting the development of atherosclerosis, in low and very low density lipoproteins (LDL and VLDL). High-density lipoproteins are not only involved in many important processes in the body, but also prevent the development of atherosclerosis, clearing blood vessels of atherosclerotic plaques.
In addition to cholesterol, there is also fatty acids, leading to the formation of atherosclerotic plaque, but not all of them are so harmful. Fatty acids are saturated and unsaturated. So, saturated fatty acids are involved in the development of atherosclerosis, and unsaturated fatty acids, on the contrary, strengthen the vascular cell and help prevent the formation of atherosclerotic plaques.
Therefore, you should not completely exclude cholesterol and fats from your diet, but you need to eat healthy fats.
Foods with healthy fats:
- many types vegetable oil(sunflower, olive, sesame, corn, soy and so on);
- many nuts (peanuts, walnuts, hazelnuts, sesame and others);
- butter;
- avocado;
- fish, especially salmon;
- soy and so on.
Pay attention to your diet, and you can prevent not only atherosclerosis, but also many other diseases (diabetes, obesity, hypertension, gout, etc.).
What vitamins and biologically active substances are needed for atherosclerosis?
Vitamins play important role in many processes in the body are biologically active substances(participating in metabolism) and antioxidants(compounds that prevent the oxidation of many substances in the body). Vitamins also play an important role in the treatment and prevention of atherosclerosis. Of course, it is important to balance your diet across all groups of vitamins and microelements, but there are a number of vitamins that are needed first.
Vitamins that improve the condition of the vascular wall, vascular patency and contribute to the prevention and treatment of atherosclerosis:
1.
Nicotinic acid or vitamin PP– dilates peripheral blood vessels, promotes oxygen supply to tissues. Appointment required dosage forms nicotinic acid and foods rich in this vitamin
:
- grain crops , cereals, whole grain products;
- eggs;
- many nuts and fruit seeds, seeds;
- mushrooms;
- seafood;
- poultry meat;
- liver;
- tea and so on.
3. B vitamins(B1, B6, B12, B15 and other representatives of this vitamin group):
- improvement of work nervous system, regulation of vascular tone, participation in the regulation of blood pressure;
- participation in fat metabolism;
- participation in maintaining normal cellular composition blood.
- cereals, grains, bran;
- green;
- vegetables;
- liver and many other products.
This vitamin is found in the following foods:
- vegetable oils;
- nuts and seeds;
- mustard;
- vegetables and herbs;
- papaya and avocado.
6. Minerals:
- iodine reduces cholesterol levels in the blood, found in seafood, baked potatoes, cranberries and prunes;
- selenium contribute more rapid recovery an organ subjected to ischemia and hypoxia is found in cereals and cereals, liver, green vegetables, nuts;
- magnesium reduces cholesterol levels in the blood, improves the functioning of the cardiovascular system, is contained in sufficient quantity in seafood, cereals, grains, legumes, nuts, many vegetables and so on;
- chromium participates in fat metabolism and helps normalize blood pressure; foods rich in chromium: fish, liver, pearl barley, beet.
- unsaturated fatty acids (namely the Omega-3 complex contained in fish oil);
- amino acids (arginine and taurine) are found in meat, dairy products, eggs, fish, soybeans, grains and so on;
- phospholipids (lecithin) – eggs, fish roe, fish, legumes, grains, etc.
Atherosclerosis is a common progressive disease that affects large and medium-sized arteries as a result of the accumulation of cholesterol in them, leading to poor circulation.
In economically developed countries, atherosclerosis is the most common cause morbidity and overall mortality.
Causes of atherosclerosis
The following roles play a role in the occurrence and formation of atherosclerosis:
- lipid (fat) metabolism disorders;
- hereditary genetic factor;
- condition of the vascular wall.
Cholesterol is a lipid (fat) and has many functions important functions in the human body. He is building material for the walls of body cells, is part of hormones, vitamins, without which normal human existence is impossible. Up to 70% of cholesterol in the body is synthesized in the liver, the rest comes from food. In the body, cholesterol is not in a free state, but is part of lipoproteins (complex compounds of protein and fats) that transport it through the bloodstream from the liver to the tissues, and if there is excess cholesterol, from the tissues back to the liver, where the excess cholesterol is utilized. If this process is disrupted, atherosclerosis develops.
The main role in the development of atherosclerosis belongs to low-density lipoproteins (LDL), which transport cholesterol from the liver into cells; there must be a strictly required amount; by exceeding its level, the risk of atherosclerosis is determined.
The reverse transport of cholesterol from tissues to the liver is ensured by high-density lipoproteins (HDL), an antiatherogenic class of lipoproteins. It cleanses the surface of cells from excess cholesterol. Level Up LDL cholesterol and lowering HDL cholesterol levels increases the risk of atherosclerosis.
Initial changes in the wall of large and medium-sized arteries occur in at a young age and evolve to fibroadenomatous plaques, which often develop after age 40. Atherosclerotic vascular damage already occurs in persons under 20 years of age in 17% of cases, under 39 years of age in 60% of cases, and in persons 50 years of age and older in 85% of cases.
To the middle arterial wall cholesterol, fibrin and other substances penetrate, which subsequently form an atherosclerotic plaque. Under the influence of excess cholesterol, the plaque increases, and obstacles arise to the normal flow of blood through the vessels at the site of narrowing. Blood flow decreases, an inflammatory process develops, blood clots form and can break off, with the danger of clogging vital vessels and stopping the delivery of blood to organs.
Factors that play a role in the development and progression of atherosclerosis are:
- modifiable (which can be eliminated or adjusted)
- non-modifiable (they cannot be changed).
Modifiable factors include:
1.Lifestyle:
- physical inactivity,
- abuse of fatty, cholesterol-rich foods,
- personality and behavior characteristics - stressful type of character,
- alcohol abuse,
- smoking.
2. Arterial hypertension, blood pressure 140/90 mm Hg. and above.
3. Diabetes mellitus, fasting blood glucose level more than 6 mmol/l.
4. Hypercholesterolemia (increased blood cholesterol levels).
5. Abdominal obesity(waist circumference in men is more than 102 cm and more than 88 cm in women).
Non-modifiable factors include:
1. Age: men over 45 and women over 55 or with early menopause.
2. Male gender (men before women by 10 years they develop atherosclerosis).
3. A family history of cases of early atherosclerosis. Familial hypercholesterolemia with a genetic basis. Myocardial infarction, stroke, sudden death the closest relatives are under 55 years of age for men and 65 years for women.
The adverse effects of risk factors lead to disruption of the integrity of the endothelium ( inner layer vessels), which loses its barrier function, against the background of lipid metabolism disorders lead to the development of atherosclerosis.
Symptoms of atherosclerosis.
The deposition of cholesterol in the arterial wall is accompanied by a compensatory bulging outward, due to which there are no obvious symptoms of atherosclerosis for a long time. But over time, the atherosclerotic plaque transforms from stable to unstable under the influence of systemic factors: physical activity, emotional stress, arterial hypertension, disorder heart rate. They lead to cracks or rupture of the plaque. Blood clots form on the surface of an unstable atherosclerotic plaque - atherothrombosis is formed, leading to progressive vasoconstriction. There is a disturbance in blood circulation in organs and tissues, and clinical symptoms noticeable to the patient appear.
Depending on the location in vascular system, atherosclerosis is the basis of such diseases:
1. Coronary heart disease (angina pectoris, myocardial infarction, sudden cardiac death, arrhythmias, heart failure).
2. Cerebrovascular diseases (transient ischemic attack, ischemic stroke).
3. Atherosclerosis of the arteries of the lower extremities (intermittent claudication, gangrene of the feet and legs).
4. Atherosclerosis of the aorta.
5. Atherosclerosis of the renal arteries.
6. Atherosclerosis of the mesenteric arteries (intestinal infarction).
The atherosclerotic process leads to damage to several vascular beds. After a stroke, the likelihood of developing a myocardial infarction in such patients is 3 times higher, and damage to the peripheral arteries increases the risk of developing myocardial infarction by 4 times, and stroke by 3 times.
Atherosclerosis of the coronary arteries has many symptoms, depending on the severity of atherosclerosis, manifested by angina pectoris or acute coronary insufficiency, characterized by the development of myocardial infarction and heart failure. All forms coronary disease heart disease occurs against the background of atherosclerosis. Cardiac manifestations of atherosclerosis account for approximately half of all atherosclerotic lesions.
Atherosclerosis of the aorta often appears after 60 years. With atherosclerosis of the thoracic aorta, intense burning pain behind the sternum, radiating to the neck, back, upper abdomen. With physical activity and stress, the pain intensifies. Unlike angina, the pain continues for days, periodically intensifying and weakening. Swallowing problems, hoarseness, dizziness, and fainting may occur. Atherosclerosis of the abdominal aorta is characterized by abdominal pain, bloating, and constipation. With atherosclerotic lesions of the aortic bifurcation (the place where the aorta divides into branches), Leriche syndrome develops with such manifestations as: intermittent claudication, coldness of the lower extremities, impotence, toe ulcers. A serious complication of aortic atherosclerosis is aneurysm (dissection) and rupture of the aorta.
Atherosclerosis of the mesenteric vessels manifests itself as sharp, burning, cutting pains in the abdomen during meals, lasting 2-3 hours, bloating, stool disturbances.
Atherosclerosis of the renal arteries is characterized by a persistent increase in blood pressure and changes in urine analysis.
Atherosclerosis of the peripheral arteries is manifested by weakness and increased fatigue of the leg muscles, a feeling of chilliness in the limbs, intermittent claudication (pain in the limbs appears while walking, forcing the patient to stop).
Examination for atherosclerosis.
The primary diagnosis of atherosclerosis is carried out by a general practitioner or family doctor during an annual medical examination. Measures blood pressure, determines body mass index, identifies risk factors (hypertension, diabetes, obesity).
1. Determination of lipid levels, after 30 years:
- total cholesterol (norm less than 5.0 mmol/l);
- LDL cholesterol (normal value is below 3.0 mmol/l);
- HDL cholesterol (the norm is above 1.0 mmol/l (in men) and above 1.2 mmol/l (in women);
- blood plasma triglycerides (the norm is below 1.2 mmol/l);
- ratio of total cholesterol/HDL cholesterol (atherogenic index – a factor in the development of cardiovascular complications). Low risk - from 2.0 to 2.9, medium risk - from 3.0 to 4.9, high risk - more than 5.
2. Determination of the risk group in patients without clinical manifestations atherosclerosis. The SCORE (systemic coronary risk assessment) scale allows you to determine the individual degree of risk for patients, with which you can assess the likelihood of fatal cardiovascular events. vascular events(myocardial infarction, stroke) for 10 years. Low risk -<4%, умеренный риск - 4–5%, высокий риск - 5–8% и очень высокий риск - >8%.
If you suspect atherosclerotic changes consultation with specialists is indicated:
- cardiologist (for coronary heart disease);
- ophthalmologist (atherosclerosis of the fundus vessels);
- neurologist (cerebral atherosclerosis);
- nephrologist (atherosclerosis of the renal arteries);
- vascular surgeon(atherosclerosis of the vessels of the lower extremities, aorta).
To clarify the degree of atherosclerotic lesions, additional instrumental research methods may be prescribed:
1. Electrocardiography, with stress tests, ultrasound examination heart, aorta.
2. Angiography, coronary angiography, intravascular ultrasound. These are invasive research methods. Atherosclerotic plaques are identified and the total atherosclerotic lesion can be assessed. Used in patients with clinical manifestations of atherosclerosis (coronary heart disease).
3. Duplex and triplex scanning. Study of blood flow with ultrasound visualization of vessels: carotid arteries, abdominal aorta and its branches, lower and lower arteries upper limbs. Detects atherosclerotic plaques in the arteries and assesses the state of blood flow in the vessels.
4. Magnetic resonance imaging. Visualization of arterial walls and atherosclerotic plaques.
Treatment of atherosclerosis.
1. Without clinical manifestations of atherosclerosis, lifestyle modification is recommended for a patient with a moderate risk (up to 5% on the SCORE scale) and a total cholesterol level above 5 mmol/l. It includes: quitting smoking, drinking alcohol, anti-atherosclerotic diet, increasing physical activity. When the target cholesterol level is reached (total cholesterol up to 5 mmol/l, LDL cholesterol below 3 mmol/l), re-examination should be carried out at least once every 5 years.
Starting treatment for a patient with high risk(above 5% SCORE) and total cholesterol levels above 5 mmol/L should also begin with recommendations for lifestyle changes for 3 months and re-evaluate at the end of this period. When the patient reaches target levels of total cholesterol up to 5 mmol/L and LDL cholesterol below 3 mmol/L, lipid levels are subsequently monitored annually. If the risk remains high (above 5% on the SCORE scale), drug therapy is prescribed.
2. For patients with signs of atherosclerotic lesions of any location, lifestyle modification and drug therapy are recommended.
Diet recommendations are given to all patients, taking into account cholesterol levels and other risk factors: obesity, arterial hypertension, diabetes mellitus. Diet should be varied, in accordance with the cultural traditions of the patient. The caloric content of the daily diet should be sufficient to achieve and maintain normal weight.
Consumption of total fat should not exceed 30% of the calorie intake.
It is recommended to limit the consumption of animal fats (butter, cream, meat, lard), replacing them with vegetable fats. Daily consumption fresh vegetables and fruit should be at least 400g per day.
It is recommended to consume lean meat and poultry without skin, fermented milk products, low-fat cottage cheese, grain bread, with bran, products enriched with ω3-unsaturated fatty acids(sea and ocean fish - salmon, mackerel, tuna, etc.). Limiting consumption table salt up to 6g per day, which corresponds to 1 teaspoon. Following a diet can reduce cholesterol levels by up to 10%.
Normalization of body weight indicators.
Excess body weight and obesity, especially abdominal obesity (waist circumference in men more than 102 cm and more than 88 cm in women), increase the risk of developing cardiovascular diseases. To lose weight, an individual diet is selected taking into account age and concomitant diseases.
Physical activity for atherosclerosis.
Increasing physical activity has a positive effect for patients with atherosclerosis.
Patients without clinical manifestations of atherosclerosis are advised to exercise for 40 minutes daily. The intensity of the exercise should be 60% of the maximum heart rate (calculated = 220 - age).
Cardiovascular patients vascular diseases a constant regime of dynamic physical activity is required, taking into account the results of stress tests. Walking, swimming, dancing are useful - moderate intensity 60-90 minutes per week. Isometric (power) loads are unacceptable.
Stop smoking.
Smoking (active and passive), as a result sharp decline HDL (an anti-atherogenic class of lipoproteins), pathological effects on the vascular system, disturbances in the rheological properties of blood - increases the risk of morbidity and mortality from cardiovascular complications by 20%. Smokers are at risk of developing ischemic stroke 2 times higher than that of non-smokers.
Drinking alcohol.
Health-safe alcohol consumption - no more than 20-30 ml of pure ethanol per day for men and no more than 20 ml per day for women, only for practically healthy individuals, reduces mortality from cardiovascular complications. Drinking alcohol (12-24g per day of pure ethanol) reduces the risk of developing cardiovascular complications (heart attack and stroke) by 20%, and drinking 5 servings of alcohol (60g per day) increases the risk of cardiovascular complications by 65%.
Drugs.
The use of drugs, such as cocaine, amphetamine, heroin, causes sudden changes in blood pressure, inflammatory changes in the vascular system, and leads to disruption of the rheological properties of the blood. They increase the risk of stroke by 6.5 times in people under 35 years of age, and in people over 35 years of age by 11.2 times.
Drug treatment of atherosclerosis.
Drug therapy for atherosclerosis involves the use of 4 groups of lipid-lowering (lipid level-lowering) drugs: sequestrants bile acids, nicotinic acid, fibrates, statins. These agents have a stabilizing effect on the atherosclerotic plaque, improve the function of the endothelium (the inner lining of blood vessels), and inhibit the development of atherosclerosis, while differing in the severity of their effect on various indicators of lipid metabolism.
Only the attending physician will recommend necessary drug and its dosage. The most commonly used drugs are statins. Treatment with statins significantly reduces mortality and prevents cardiovascular complications. The required dose of statins is selected individually for each patient. The drug is taken once a day - in the evening before bedtime.
Preparations based on fish oil, essential phospholipids. They are used only in combination with statins.
If there is a threat of developing complications of atherosclerosis, it is indicated surgical treatment, which restores arterial patency (revascularization). In case of coronary heart disease, coronary artery stenting or bypass surgery is performed to prevent the development of a heart attack. In case of cerebral atherosclerosis, stenting of the carotid arteries is performed to prevent the development of stroke. To prevent the development of gangrene of the lower extremities, prosthetics are performed main arteries. The need and extent of surgical intervention is determined by the surgeon (cardiac surgeon, vascular surgeon).
Surgical treatment of atherosclerosis does not provide a complete cure. The complication is eliminated, not the cause that caused it (atherosclerosis). Therefore, after surgery, changes in lifestyle, nutrition and conservative treatment are mandatory.
Prevention of atherosclerosis.
Primary prevention of atherosclerosis involves:
1. Control and achievement of target cholesterol levels (total cholesterol up to 5 mmol/l, LDL cholesterol below 3 mmol/l).
2. Stop smoking, drinking alcohol, and taking drugs.
3. Adequate level of physical activity.
4. Normalization of body weight.
5. Limiting emotional overload.
6. Normal indicators blood glucose.
7. Blood pressure below 140/90 mm Hg.
8. Compliance with the principles of the anti-atherosclerotic diet.
To measures of secondary prevention aimed at preventing complications of an already developed disease, in addition to measures primary prevention This also includes taking cholesterol-lowering drugs (statins), antiplatelet agents (acetylsalicylic acid).
Consultation with a doctor on the topic of atherosclerosis:
Question: It is advisable for older and older people to take statins. old age(70-80 years old)?
Answer: Treatment of atherosclerosis with statins in older adults not only reduces the risk of stroke and heart attack, but also reduces overall mortality.
Question: How long should I take statins?
Answer: To significantly improve life prognosis and reduce the risk of cardiovascular complications, it is necessary to use statins daily for at least 3-5 years without unreasonable dose reduction and unauthorized premature cessation of treatment.
General practitioner Vostrenkova I.N.
- this is one of the serious and dangerous chronic diseases heart vessels And brain, in which single or multiple foci are formed cholesterol And lipid sediments , original atheromatous plaques , consisting of calcium, and connective tissue in inner shell arteries.
An artery whose wall is damaged becomes less elastic and, as a result, becomes denser. Gradually growing connective tissue and calcification lead to deformation and significant narrowing of the lumen between the walls of the artery until it is completely blocked, thereby causing a chronic lack of blood supply and organ ischemia, which feeds through the affected artery. Acute arterial blockage is also possible blood clots or contents from the disintegrated substance of an atheromatous plaque, which causes complications of atherosclerosis, leading to the formation of necrosis ( heart attack ) or in an organ supplied by an artery.
General damage to all arteries organism is quite rare. Very often observed blockage of blood vessels certain organs: brain and heart, lower extremities or kidneys. The progression of atherosclerosis is expressed in the fact that with intense functional load on the organ, the blood flow to it is insufficient. This leads to unpleasant sensations from the organ. The clinical picture of the disease varies depending on the location and distribution of the affected arteries. Atherosclerosis has chronic course and is the reason disability and even premature death.
Atherosclerosis is associated with an increased level of neuropsychic stress, high performance cholesterol levels, unhealthy lifestyle, lack of physical activity, smoking, etc. The average age at which atherosclerosis most often affects human body from 40 to 45 years. Men are susceptible to atherosclerosis 3, and sometimes 4 times. more often than women, this is due to the fact that the prevention of atherosclerosis in the stronger sex is often not taken seriously. In particular, men continue to smoke and drink alcohol, despite the threat of the disease.
Symptoms of atherosclerosis
Like any disease, atherosclerosis has its main signs by which the disease can be recognized. Symptoms of atherosclerosis can be varied. It all depends on the degree and location of damage to a particular vessel. Damaged blood vessels in the brain lead to insufficient blood supply and, as a consequence, to a deterioration in its functions. The first symptom in in this case is decreased memory for recent events. Diagnosis of atherosclerosis in this development of events shows irreversible changes.
Further observed emotional instability and gradual decreased intelligence. Very often, patients complain of a feeling of pulsation and “noise” in the head. All other symptoms of atherosclerosis depend to a greater extent on which part of the brain is affected. Atherosclerosis affecting the vessels of the brain very often becomes the main cause ischemic .
Complications of atherosclerosis
Atherosclerotic lesion of the aorta appears gradually increasing arterial hypertension, noises appearing in front of the abdominal aorta in the ascending direction. A complication in this case is insufficient blood supply to the brain and, as a consequence, fainting , strokes . Threatening to the life of the patient is dissecting aortic hematoma . The disease manifests itself as an attack of pain in the chest or abdominal cavity. All symptoms occur acute loss blood. The most common and life-threatening complication of aortic atherosclerosis is characterized by a sudden rupture with bleeding in chest cavity or into the abdominal space, leading to death. Aneurysm of the thoracic aorta is manifested by hoarseness of voice, rough systolic murmurs,.
The absence or a small number of symptoms make an abdominal aortic aneurysm the most life-threatening for the patient.
Atherosclerotic lesion mesenteric arteries , which nourish the intestines, is manifested by the following symptoms:
- Attacks of colic-like abdominal pain ( abdominal toad ), often with bloating and vomiting, which most often occurs after eating.
- arterial arteries with necrosis of the wall of the mesentery and intestine.
Atherosclerotic damage to the arteries and vessels of the lower extremities is characterized by the following symptoms: chilliness of the legs, pain in the calves that occurs when walking, and deformation of the nails, weakening of the pulsation of the arteries, development dry gangrene .
Atherosclerosis renal artery manifests itself chronic failure blood circulation (ischemia) of the kidney, nephrosclerosis and chronic renal failure. Renal artery thrombosis manifests itself acutely kidney pain, pain when tapping the lumbar region from the side of the formed thrombosis.
Regardless of the location of atherosclerotic lesions, two types of complications are distinguished. Chronic and acute. TO chronic complications include chronic vascular insufficiency, which is accompanied by hypoxia , atrophic and dystrophic changes in the affected organ. Acute complications are most often caused by the occurrence of blood clots, emboli and vascular spasms, in such cases, immediate treatment of atherosclerosis and its complications is required. Acute occlusion , accompanied by acute ischemia, leads to the development of heart attacks.
Diagnosis of atherosclerosis
At the first manifestations of atherosclerosis, you must immediately consult a doctor and undergo mandatory examination. Very often, atherosclerosis develops unnoticed over a period of time. long period. The general direction of diagnosing atherosclerosis as a whole is as follows:
- interviewing the patient to find out the symptoms - coronary heart disease, signs of cerebral circulatory disorders, abdominal pain,;
- Examination of the patient. Includes identifying signs of premature aging of the body. Pay attention to following signs: hair loss, as well as changes in the nail plates on the toes, excessive hair growth in ears and a number of other signs of damage to internal organs. This is followed by listening to the internal organs and palpating all accessible arteries. Analysis of detected systolic murmur at the time of listening to the heart, increased blood pressure.
- Determination of risk factors contributing to atherosclerosis. Detection of hypertension, obesity, diabetes, nervous stress, bad habits or other factors that directly affect the development of atherosclerosis.
- Laboratory and instrumental diagnostics atherosclerosis. Laboratory assessment of fatty (lipid) changes in the body. ECHO-cardiography . Ultrasound scanning vessels of the head, neck and lower extremities. Electrocardiography .
Treatment of atherosclerosis
Treatment of atherosclerosis is usually a long process. The treatment regimen, which lasts at least 6 months, includes several components. Reception hypolipidemic drugs
, which reduce blood lipid levels, improve tissue oxygenation, improve blood rheology and increase the elasticity of vessel walls. Development special diet in order to reduce the patient's cholesterol level. Stop smoking, as nicotine impairs blood circulation and promotes thrombosis. Taking medications that reduce the risk of thrombosis.
The presence of atherosclerotic plaques, which prevent normal blood supply to organs, determines the use of surgical methods treatment of atherosclerosis. The damaged area of the blood vessel and thrombus are surgically removed, and vascular prosthetics is also performed. This method is used to treat atherosclerotic lesions of the arteries of the lower extremities, internal organs and coronary heart arteries.
Doctors
Medicines
Prevention of atherosclerosis
Prevention of atherosclerosis consists of eliminating the largest number risk factors and lifestyle changes. Categorical cessation of smoking, combating obesity, increasing physical activity, eliminating stressful situations. Studies have shown that eliminating one factor contributing to the development of atherosclerosis reduces the risk of developing the disease by half. Therefore, a healthy lifestyle will help avoid diseases such as atherosclerosis.
Diet, nutrition for atherosclerosis
List of sources
- Pathophysiology of diseases of the cardiovascular system (ed. L. Lilly; Translated from English), - M.; Binomial. Knowledge Laboratory, 2003;
- Aronov D.M., Lupanov V.P. Atherosclerosis and coronary heart disease. Second edition, revised. Moscow, "Triad-X", 2009;
- Atherosclerosis/A. L. Rakov, V. N. Kolesnikov // New pharmacy. - 2002. - No. 6
