Athero Sclerosis Refers to the build-up of fats, cholesterol and other substances in and on the artery walls (plaque) which can restrict blood flow.

  1. Atherosclerosis starts with damage or injury to the inner layer of an artery. This is often caused by high blood pressure, high cholesterol, high triglycerides, smoking and other sources of tobacco, insulin resistance, obesity or diabetes, inflammation from diseases such as arthritis, lupus or infections. This results in an inflammatory reaction, leading to the development of an atheroma (plaque)

  2. The injured endothelium becomes more permeable, which encourages leukocytes and platelets to adhere to the lesion and initiate an inflammatory response. Low-density lipoproteins (LDLs) enter the tunica intima, combine with oxygen and remain stuck to the vessel wall. This oxidation of the lipoproteins attracts monocytes, which adhere to the endothelium and migrate into the wall, as they migrate, they digest the lipids and develop into structures called foam cells.

  3. Eventually smooth muscle cells from the tunica media migrate into the atheroma and proliferate, causing further enlargement of the atheroma and narrowing of the lumen of the blood vessel, thereby restricting blood flow to the regions the artery supplies. In addition, the smooth lining of the plaque may rupture, spilling cholesterol and other substances into the blood stream, this may cause a blood clot, which can block blood flow through specific arteries (such as blood blocking an artery in the heart, causing a myocardial infarction).

Primary risk factors:

  • Increased circulating lipid levels (hyperlipidaemia)

  • Hypertension – causing vessel damage (defined as systolic pressure greater than 140mmHg or diastolic pressure greater than 90mmHg)

  • Nicotine use – increased risk of oxidation of LDL, increased SNS activity aggravates supply and demand, increases platelet adhesiveness

  • Diabetes - inappropriate glycosylation of LDL, chronic inflammation

Secondary risk factors: --

  • Reduced activity

  • Obesity

  • Alcohol consumption

Treatment/ prevention: Diet: eat a healthy balance diet, avoid foods with added sugars (sugar sweetened beverages, candy), avoid foods high in salt and foods high in saturated and trans fats.