Medical Author: Melissa Conrad Stöppler, MD, Chief Medical Editor
Medically Reviewed on 3/11/2019
Doctor's Notes on Hardening of the Arteries (Atherosclerosis)
Atherosclerosis, or “hardening of the arteries” is a long-term process that leads to narrowing of the blood vessels that carry blood away from the heart due to thickening and hardening of the artery walls. This narrowing, in turn, causes a reduction in blood flow to the affected areas of the body. Factors that increase the risk of developing atherosclerosis include high levels of "bad" cholesterol, elevated blood pressure (hypertension), diabetes, smoking, and a family history of the condition. Atherosclerosis is responsible for coronary artery disease (angine and heart attacks) and strokes.
Symptoms of atherosclerosis depend on the particular artery that is affected. In coronary artery disease, associated symptoms can include chest pain either at rest or during exercise. A heart attack can be associated with a feeling of crushing or pressure in the chest. Symptoms associated with stroke include sudden numbness, weakness, confusion, trouble walking, or vision disturbances.
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Angina (Ischemic Chest Pain)
Angina pectoris is a term to describe chest pain that occurs when the heart is not getting enough blood. There are two types of angina, stable (the most common) and unstable. Stable angina generally lasts less than five minutes and is relieved by nitroglycerin tablets. Angina may be caused by heart disease, coronary artery spasm, or other causes. Risk factors for angina include high blood pressure, high cholesterol, diabetes, smoking, sedentary lifestyle, family history, aging, and stimulant use. Treatment depends upon the cause of angina. -
Aortic Aneurysm (Abdomen and Thorax - Chest)
An aortic aneurysm is a medical emergency. Abnormal enlargement or bulging of the aorta becomes an aortic aneurysm when this area becomes weakened. Some of the symptoms of an aortic aneurysm include back pain, chest pain, dizziness, sweating, nausea, and vomiting. Common causes of an aortic aneurysm include heart disease, high blood pressure, diabetes, inflammatory aneurysm, or injury to the chest wall. Treatment of aortic aneurysm depends upon the cause. -
Chest Pain
Chest pain has a variety of noncardiac and cardiac causes, some of which can be very serious. Signs and symptoms of chest pain may include burning, squeezing, or heaviness in the chest. Atherosclerosis, angina, lung tumors, chest trauma, abdominal pain, and gastric reflux are just a few potential causes of chest pain. Chest pain is diagnosed by taking the patient history and performing a physical exam. Blood work, imaging tests, and an exercise stress test may be ordered. The treatment and prognosis of chest pain depends on the underlying cause. -
Cholesterol Levels: What the Numbers Mean
Blood cholesterol levels are measured by a simple blood test. Elevated LDL cholesterol (the "bad" cholesterol), and low levels of HDL cholesterol (the "good" cholesterol) levels, and high triglyceride levels puts a person at an increased risk for heart attack or stroke. The primary goal for a person with high triglycerides or cholesterol levels is to lower them with lifestyle changes like exercise, weight loss and diet changes to include more fiber, fruits and vegetables. -
Cholesterol Test
Cholesterol tests measure the cholesterol and triglyceride levels in the blood. The test is also referred to as a lipoprotein profile or lipoprotein analysis. The test measures total cholesterol, HDL, LDL, and triglyceride levels in the blood. Few risks are associated with cholesterol tests. -
Heart Attack
A heart attack is an interruption in blood flow to the heart muscle. Arterial plaque rupture is often the cause of a heart attack. Symptoms of a heart attack may include chest pain, shortness of breath, sweating, and nausea. Emergency heart catheterization and thrombolytic therapy may be used to treat a heart attack. -
Heart Disease
Coronary heart disease (CHD) is a group of different types of heart disease. Symptoms of heart disease depend on the cause and inclue chest pain or angina, shortness of breath, palpitations, and dizziness. Many conditions causes heart disease, for example, genetics, obesity, high cholesterol, and smoking. Treatment for heart disease depend on the cause and include diet and other lifestyle changes, medications, procedures, and surgery. The prognosis (outlook) and life span for someone with heart disease varies depending on the cause. -
High Blood Pressure (Hypertension)
High blood pressure (hypertension) may be present in an individual, without any symptoms. Thus, it is called the "silent killer." Causes of high blood pressure include heart disease, kidney disease, tumors, birth control, alcohol, thyroid dysfunction, and birth control pills.Treatment of high blood pressure is generally through diet, exercise, and medication if necessary. -
High Cholesterol
High cholesterol levels can lead to heart disease, stroke, angina, blood clot formation, stroke, and peripheral artery disease. Causes of high cholesterol include heredity, age, gender, stress, and lifestyle choices. Cholesterol levels can be reduced with lifestyle changes and medication if necessary (statins, fibrates, bile acid sequestrants, or niacin). -
High Cholesterol: Medications to Lower
Cholesterol is a waxy, fatlike substance that your body needs to function normally. If a person has too much cholesterol in their bloodstream, it can lead to heart disease. Cholesterol lowering medications include statins (Lipitor, Lescol, Mevacor, Altocor, Pravachol, Zocor, and Crestor), bile acid sequestrants (Questran, Colestid, WelChol), nicotinic acid agents (niacin, Niacor, Slo-Niacin), and fibrates (Lopid, Tricor). Side effects, drug interactions, and warnings and precautions should be reviewed prior to taking these medications. -
How to Lower Cholesterol
Cholesterol is a waxy, fat-like substance that is naturally present in the body. Diets high in fat, inactivity, and obesity contribute to high cholesterol. Some factors such as genetics are uncontrollable for having high cholesterol. You can lower your cholesterol levels naturally with lifestyle changes such as weight loss and control, exercise, diet, and quitting smoking. If these measures don't lower cholesterol enough a person may need to take cholesterol medications. -
Peripheral Vascular Disease (PVD)
Peripheral vascular disease (PVD or peripheral artery disease) refers to any disease or disorder of the circulatory system outside of the brain and heart. Common causes of peripheral vascular disease include blood clots, diabetes, inflammation of the arteries, infection, structural defects, and injury. Symptoms of peripheral artery disease include buttock pain, numbness, tingling, or weakness in the legs, burning or aching pain in the feet or toes while resting, a sore on a leg or a foot that will not heal, one or both legs or feet feel cold or change color (pale, bluish, dark reddish), loss of hair on the legs, and impotence. Tests are used to diagnose peripheral vascular disease. Treatment guidelines include medication, lifestyle changes, and if necessary, surgical intervention. -
Statins (Cholesterol Lowering Drugs)
Statins are a class of drug prescribed for reducing blood cholesterol levels in individuals with high cholesterol. Examples of statins available include atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor, Altocor), pravastatin (Pravachol), pitavastatin (Livalo), simvastatin (Zocor), and rosuvastatin (Crestor). Common side effects include brown, discolored urine, vomiting, muscle weakness, leg pain, muscle soreness, and stomach cramps. Drug and food interactions, warnings and precautions, and serious side effects should be reviewed prior to taking any medication.
REFERENCE:
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.