Atherosclerosis: what is it, types. What is atherosclerotic plaque?
Atherosclerosis is a chronically occurring disease, the substratum of which are artery. Thus there is violation of blood supply of organs and systems. This leads to the development of vascular complications in the form of heart attacks and strokes. In the structure of mortality of atherosclerosis is about 58%. This disease affects men and women older than 30 – 35 years. Their number increases with age.
How is this happens?
Atherogenesis – the process of atherosclerotic changes. It consists of successive stages. Pathogenesis can be divided into the following stages:
- Deposition and transformation of lipoproteins. On the background of dyslipidemia in the inner layer of blood vessels of pathological changes, which lead to the deposition of cholesterol and other substances. Lipid stains are made up of atherogenic substances (LDL and VLDL). In the intima of blood vessels, these substances enter into oxidation reactions and subjected to non-enzymatic glycosylation. In the course of these processes form aggressive peroxides, which continues the process of damage, and oxidized LDL conglomerate.
- Leukocyte migration and the emergence of a pool are also ksantomnye cells. Receptor apparatus of the vascular endothelium is exposed to modified LDL. It stimulates the introduction of lipid stain the leukocytes, forming atherosclerotic plaque. Macrophages engulf modified LDL and remain in the chamber in the form are also ksantomnye cells. The plaque increases. The flow of blood in the place of her education ceases to be laminar. This increases adhesion of the next batch of LDL.
- The selection of factors enhance the formation of the plaques. Macrophages absorb LDL and secrete substances (cytokines) that enhance the growth of the conglomerate. Strengthening mechanisms for the pathological process several. Especially important are: the stimulation of division in the plaque of the elements smooth muscles, secretion of growth factor (fibroblasts), further effect on the receptors that increase the flow in the hearth of monocytes and PL.
- The increase in the number of smooth muscle elements in atherosclerosis. Under the action of chemical stimulants (cytokines) increases the rate of division of the muscle elements in the intima of the vascular wall and migration of elements from the media. These cells contribute to the increased synthesis of fibrous substrate layers.
- The development of complicated plaques. At this stage changes the balance in the coagulation system. Damage to the vascular wall lead to the adhesion to the rupture of platelets. Blood cells secrete substances that enhance the process of fibrosis. The formed blood clots or continue to grow or dissolve, and in plaque begin to grow into the vessels. This increases the delivery of leukocytes to the plaque. Unbreakable injured vessels, by increasing the amount of hemosiderin and fibrin, which contributes to calcification of the plaque.
The increase in the thickness of plaque makes the inner diameter of the vessel is less. Reduction of blood flow leads to insufficient blood supply of organs, belonging to the basin of the arteries that are affected in disease. Atherosclerotic vascular disease of the brain, lungs, and carotid arteries causes the greatest number of complications.
What contributes to the development of the disease?
Atherosclerotic disease develops under chronic exposure causes transmitted genetically and occurs in patient’s lifetime. There are the most important risk factors:
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- an increase in the level of lipids in the blood;
- increase in blood pressure;
- the presence of metabolic syndrome or diabetes;
- the presence of obesity;
- reduction in motor activity;
- chronic stress;
- violation of diet;
- the presence of genetic factors;
- postmenopausal period;
- the increase in the level of fibrinogen in the blood;
- urinary excretion of homocysteine;
- lowering thyroid function.
Classification of atherosclerosis
There are several classifications of the disease. Kinds of arteriosclerosis are divided according to the criteria taken as a basis. The types of pathological process are different:
- according to the leading pathogenetic cause of the disease is divided into hemodynamic (in the presence of arterial hypertension), metabolic (disorders of metabolism) and mixed (combined) type;
- at the place of occurrence of atherosclerotic plaques isolated aortic atherosclerosis, precerebral and cerebral arteries, coronary arteries, renal arteries, mesenteric vessels and arteries of the lower extremities;
- the phases of the disease note the progression, stabilization and regression;
- at the time of occurrence of the disease differentialsa at the initial and clinically distinct periods (ischemic, fibrotic, necrotic stage);
- the degree of reduction of vessel lumen and secrete destinatarului and constrictive (obliterative) type.
Prevention of atherosclerosis
Knowing what is atherosclerosis, for the prevention of the disease is necessary to observe a complex of preventive measures. They consist of several areas:
- Refusal of Smoking. This not only helps to slow down the initial vascular injury, but also reduce the rate of progression of existing atherosclerotic process.
- Reducing the amount of salt. You should give preference to those dishes which you make yourself. This will help to eliminate salt from the diet. It can be replaced with seasonings and spices to enhance the taste of foods.
- The transition to gipoholesterinovu diet. For this purpose from the diet is excreted refractory fats (butter, margarine, etc.). Excludes consumption of fatty meat (pork), sausages, egg yolks. Not allowed serve pastries with added fats. Deep-fried food (chips), fatty dairy products (cheese, condensed milk, sour cream, cream) and dishes with their use is also not recommended.
- Normalization of body weight. The presence of obesity leads to dyslipidemia and strengthen the processes of deposition of LDL on the walls of blood vessels. Weight normalization is required not only physical exercise and low-calorie diet, but also the treatment of diseases caused by obesity (diabetes, etc.).
- Increasing the level of physical activity. Recommendations in this section should consider the existing starting level of fitness, presence of comorbidity, and patient age.
As the disease manifests itself?
The symptoms depend not only on the stage of the pathological process. In large measure, the clinical manifestations are determined by the localization of important changes. Atherosclerosis of vessels of a neck diagnosis of the disease can occur upon detection of its complications (stroke). Less frequently the disease is manifested by weakness, rapid fatigue.
With atherosclerosis of the brachiocephalic arteries associated dizziness by reducing blood pressure, with a sharp turn of the head or change of body position in space. This may experience worsening of memory and performance. Diffuse atherosclerosis of the vessels of the brain can cause multiple complaints. Emotional instability, tendency to depression, headache and fainting can also be caused by the presence of atherosclerotic plaques. Patients have atherosclerotic encephalopathy. If the process touched uniceramic departments brachiocephalic arteries, then these complaints may be added the symptoms of irregular and insufficient blood supply of the shoulder girdle on the right.
If there is coronary atherosclerosis, patients complain of pain in the heart, irregular heartbeat and heart failure. This diffuse process may be a godsend in case the patient has a heart attack or sudden death.
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Generalized atherosclerosis has a variety of symptoms. It is characterized by the fact that the body of the patient there are several schools of atherosclerotic changes. The clinical picture can be varied – it depends entirely on where these pockets.
Obliterating atherosclerosis of the lower extremities characterized by the appearance of alternating lameness. Pain, numbness, and convulsions occur during the load and are alone. The repetition of the loads of the complaint returned.
How to treat the disease?
To fight disease in several ways:
- Conservative methods. Medical treatment includes drugs aimed at blocking the receipt of cholesterol, a decrease in its synthesis or increased catabolism and elimination from the bloodstream of LDL. The use of anion exchange resins, vegetable sorbents, etc. affect the absorption of cholesterol. Statins and fibrates are the standard in the treatment of atherosclerosis. The use of unsaturated fatty acids with caution used in patients with hyperglycemia. The use of drugs with endotheliotropism mechanism of action reduces the amount of cholesterol in the intima of blood vessels.
- By surgical methods. To get rid of atherosclerotic plaques is possible by means of surgery. Depending on the localization of the stenosis is chosen by open or closed method of intervention. Can be quickly removed herself plaque, straightened the tortuosity of the vessel and expanded lumen.
- Folk remedies. They include prevention methods, nutritional therapy and normalization of a healthy lifestyle. Of herbal remedies the most popular garlic, hawthorn, grapefruit, lemon juice, peach juice (with pulp), figs, persimmons, prunes, apples, strawberries and raspberries. For the treatment of atherosclerosis used cucumbers, tomatoes, radish, potatoes, onions, honey, etc.