What is Atherosclerosis?
Arteries carry oxygen-rich blood from the heart to the entire body. Atherosclerosis is damage of the artery wall due to inflammation.
Atherosclerosis is often called “hardening of the arteries” due to the calcium deposits in the plaque. When your artery walls thicken with plaque, blood flow can be blocked. But the more dangerous consequence is the sudden rupture of plaque that causes an "attack" or "stroke."
The artery wall has 3 layers: the outer layer comprised of connective tissue; the middle layer known as the media made of smooth muscle and elastic fibers; and the inner layer known as the intima made of endothelial cells.
Plaque grows due to complicated interactions between genetics, high blood pressure, lipids, inflammation, diabetes and other conditions. Plaque progresses as follows:
Fresh soft lipid reach plaque is like a new wound. It is the most dangerous stage of plaque evolution, the most likely to rupture and cause a heart attack or stroke
Heterogeneous plaque is like a healing wound. It can still rupture or erode because inflammation has not resolved. It is the most common stage seen on imaging of arteries
Calcified plaque is scar that results when plaque heals. Like any scar, we carry it for the rest of our lives. Calcified plaque is a rupture related event that could have happened, but didn’t.
As plaque is developing, inflammation makes it vulnerable to rupture. A clot forms in the artery lumen. If the clot blocks an artery in your heart, you experience a heart attack, and if it blocks an artery feeding your brain, you experience a stroke. Both can result in death or disability. But both can be prevented by making artery walls thinner and healthier.
Atherosclerosis and its progression is not inevitable as we age. Using new science, new tests and new treatments, we can halt or regress the disease in our arteries. We reverse arterial disease. We reduce the risk of heart attack and stroke.