Arteriosclerosis - signs, causes and therapy

Arteriosclerosis (arteriosclerosis) is a widespread disease in modern industrial nations, in which the arteries are permanently damaged by deposits on the inner walls of the vessel. The arteriosclerosis usually develops over years, before the first symptoms appear. The consequences for the cardiovascular system are dramatic and often cause the death of patients in the long term.

contents

• definition
• symptoms
• Causes of arteriosclerosis
• diagnosis
• treatment
• Medicinal arteriosclerosis therapy
• Invasive treatment options
• Naturopathy in arteriosclerosis
• Homeopathy in arteriosclerosis
• prevention

definition

Arteriosclerosis refers to a systemic disease of the arteries caused by deposition of blood lipids (cholesterol), fatty acids, small amounts of lime, collagen (connective tissue) and proteoglycans (special proteins) on and in the cells of the inner walls of the arteries. The arteries are narrowed by the deposits and suffer due to the calcification also in their elasticity. Arteriosclerosis therefore describes chronic progressive degeneration of the arteries.

In principle, the atherosclerotic event can occur in all arterial vessels of the body. If only small blood vessels are affected, this is called microangiopathy, while larger blood vessels are referred to as macroangiopathy. As a special form, the mediasclerosis is known. The muscle layer of the media (middle vessel wall) calcifies particularly strongly.

Atherosclerosis causes increased damage to the blood vessels and serious health consequences. Image: www.fotolia.com © pixelcomet

symptoms

As a disease of the arterial system, arteriosclerosis usually develops asymptomatic for years and causes no complaints. However, as soon as blood flow through the narrowed arteries is significantly reduced or blocked, obvious signs of the disease become apparent. The recognizable symptoms depend on which vessels in the body block the blood flow. For example, if arteries that supply the brain with blood are involved, a stroke with symptoms such as headache, blurred vision, dizziness, and hemiplegia may be the result of arteriosclerosis.

If the calcification hinders the blood flow in the area of ​​the heart, this can cause a puncture in the chest, heartache or chest pain and angina pectoris (pressure and tightness in the chest) as symptoms. A common consequence of arteriosclerosis in the heart is coronary heart disease, in which the function of the coronary arteries is impaired and the circulation of the heart muscles is no longer guaranteed to the required extent. In the long term, cardiac arrhythmia, cardiac insufficiency, and in the worst case a heart attack, are threatening as a result of calcification in the heart.

In the course of calcification, if blood vessels in the area of ​​the kidneys become narrowed or blocked, high blood pressure can be observed as a typical symptom. At worst, there is a risk of life-threatening renal insufficiency (renal failure) due to the lower blood flow to the organ. In addition, arterial calcifications in the femoral arteries under load, but sometimes even when walking short distances, pain in the legs recorded. The calcification of the leg arteries can also cause swelling of the legs or thick legs. In the worst case, the tissue in the legs dies and amputation is required. Comparable impairments threaten with vascular calcification in the arteries. Narrowing of the pelvic arteries is considered to be a possible trigger for male impotence.

Narrowing and occlusion (thrombi) of the arteries can also lead to the death of the tissue elsewhere in the organism, thus potentially causing life-threatening blood poisoning. Due to the hardening of the arteries, so-called aneurysms (arterial dilatations) also form on the vessels, which in turn disturb the blood flow and possibly end in a rupture of the arteries. If such enlargement occurs in the area of ​​the abdominal aorta (abdominal aortic aneurysm), the patients show nonspecific symptoms such as abdominal pain, back pain and a strong feeling of dizziness. If a rupture of the aorta threatens life-threatening bleeding. In such cases, patients experience extreme pain and not infrequently a so-called shock symptom with a marked drop in blood pressure, a feeling of severe respiratory distress and fear of death.

For all the above symptoms, a visit to the doctor is strongly advised, as serious health problems threaten that may in many cases lead to the death of the patient.

Causes of arteriosclerosis

The immediate cause of arteriosclerosis (literally: hardening of the artery) is the accumulation of cholesterol, fatty acids and calcium in and around the vascular cells. Followed by connective tissue growths, a hardening and thickening of the vessels as well as corresponding constrictions and a loss of elasticity. However, the underlying mechanism has not yet been fully explored.

Arteriosclerosis is one of the major causes of a heart attack. Image: www.fotolia.com © psdesign1

The different theories regarding the development of atherosclerosis are in agreement that in the course of the disease, the cells of the inner vessel wall (intima) and partly also of the middle vessel wall (media) are subject to chronic herd-like changes. The accumulation of LDL cholesterol causes so-called foam cells in the area of ​​the intima, which trigger an inflammatory reaction that can also be transferred to the cells of the media. The tissue changes in the form of so-called arteriosclerotic plaques and the dying foam cells are covered with connective tissue. This reduces the cross section of the artery, which can already significantly impede blood flow. If the arteriosclerotic plaques break open, blood clotting reactions occur on their surface, which further reduces the diameter of the arteries and, in the worst case, a thrombus completely occludes the artery. Also, due to the tissue change, the elasticity of the artery decreases and this becomes downright brittle.

Numerous developmental risk factors have been identified in epidemiological and clinical studies, with arterial hypertension, obesity, hyperlipidemia (high blood lipid levels), hypercholesterolemia (high cholesterol), and diabetes mellitus being among the most prevalent causes of arteriosclerosis. Significant influence on the development of arteriosclerosis is also attributed to diet and lifestyle. High-calorie and high-fat foods, lack of exercise, stress and tobacco consumption favor vascular calcification. Certain diseases such as gout, hyperthyroidism, rheumatoid arthritis or chronic polyarthritis are also associated with the development of arteriosclerosis. Furthermore, the risk of atherosclerosis increases significantly in patients with chronic renal failure. Although women are less likely to suffer from arteriosclerosis than men, the risk of menopause increases due to estrogen deficiency.

A particular influence on the development is generally attributed to cholesterol, wherein an increased concentration of LDL cholesterol (low density lipoprotein) and triglycerides should also favor arteriosclerosis, as well as a reduced concentration of HDL cholesterol (high density lipoprotein). However, a particularly important role of cholesterol levels in the risk of atherosclerosis has not been scientifically proven. The often implied relationship with cholesterol levels and the relevant dietary intake of animal fats remains controversial to this day.

diagnosis

If atherosclerosis is suspected, the patient's individual disease risk is first estimated based on simple questions about diet, the profile of exercise, tobacco use, and past medical conditions (eg, diabetes, past heart attacks, and stroke). This is followed by initial physical examinations, such as a walk - on test (pain on walking is an indication of arteriosclerosis), or Ratschow 's storage test, where patients lie on their backs, holding their legs up, and for a maximum of two minutes (or until Onset of pain) move their feet. The legs are then left to rest in the normal sitting position and the time to reach the venous filling is measured. These times are significantly prolonged in arteriosclerosis. For example, in healthy patients, after five seconds, if the feet are slightly diffuse reddened, it may take up to a minute for patients with atherosclerosis.

If the first physical examinations are suspected, further examinations will be carried out to verify the findings, such as sonography (ultrasound examination), magnetic resonance imaging (MRI) or computed tomography (CT) of the arteries. Special angiography procedures can be used to image complete vascular structures. In addition, there is usually a blood test in the laboratory, in which the cholesterol levels, blood sugar levels, uric acid levels, the concentration of asymmetric dimethylarginine (ADMA), the amino acid homocysteine ​​and glycohaemoglobin are measured. If the follow-up examinations confirm the suspicion of arteriosclerosis, appropriate therapeutic countermeasures should be initiated immediately and it is advisable to consult a vascular specialist.

treatment

An essential part of the therapy is the change to a healthy diet and sufficient exercise. Up to the formation of the foam cells in the blood vessel, the arteriosclerosis is even quite reversible or curable with these simple measures. Endurance sports are especially recommended as exercise, but even light physical activities, such as a walk, can already have a significant positive effect. Jogging, cycling and swimming are other typical sports recommended by experts in arteriosclerosis treatment.

The diet has a particularly sustainable effect. In the context of the therapy, therefore, the conversion to a so-called Mediterranean diet with the highest possible proportion of vegetables, fruits and wholegrain products is recommended. Patients should be aware of adequate fiber intake as it will lower LDL cholesterol levels. An opposite effect produces saturated fatty acids, which should therefore be avoided as far as possible. However, monounsaturated fatty acids are highly recommended as they lower LDL cholesterol levels without affecting beneficial HDL cholesterol. Polyunsaturated fatty acids, such as omega-6 fatty acid or omega-3 fatty acid, lower total cholesterol. They are contained for example in different types of fish and nuts. A positive effect is also attributed to antioxidants, such as vitamin E or vitamin C, which are found in many types of fruit. Especially the juice of the pomegranate is considered to be particularly healthy for the vessels.

Medicinal arteriosclerosis therapy

Also, medicines are used in the context of treatment, but these do not remedy the vascular deposits itself, but merely to alleviate the symptoms or counteract the risk of arteriosclerosis, such as lipid metabolism disorders, high blood pressure and diabetes. If the blood flow is already impaired by arteriosclerosis, blood-thinning medicines or anticoagulants such as acetylsalicylic acid, clopidogrel or dipyridamole are often part of arteriosclerosis therapy. These are intended to facilitate blood flow and prevent more severe consequences of arteriosclerosis such as a heart attack or stroke.

Hypertension as a risk factor of atherosclerosis is often used to reduce blood pressure, such as ACE inhibitors, beta-blockers, diuretics or AT1 receptor blockers. If there are problems with the cholesterol level, prescribing cholesterol lowering medicines is part of conventional arterial sclerosis therapy. Also, the blood can be freed by a so-called apheresis of the harmful LDL cholesterol, which, however, is usually only in patients with genetically determined extremely high LDL cholesterol levels in question. In the procedure, the blood is drained via a vein of the arm, cleared of fats and returned to the bloodstream via a second arm vein. At regular intervals, the apheresis must be repeated. The drug treatment of an existing diabetes mellitus is also important for atherosclerosis therapy because diabetes is considered one of the major risk factors for arteriosclerosis. The optimal adjustment of the sugar level with antidiabetics and a correspondingly adapted diet can therefore make a significant contribution to reducing the risk of atherosclerosis.

Invasive treatment options

In addition to the pharmacological arteriosclerosis therapy also exist invasive treatment options such as a bypass surgery or an expansion of the arteries using a small balloon. The invasive procedures are used almost exclusively in particularly severe cases of arteriosclerosis, in which further complications, such as a heart attack, threaten. The aim of surgical interventions is usually the elimination of vascular constrictions, with a dilation with subsequent attachment (so-called stent) or a removal of the tissue are to be mentioned as options. Thrombendarterectomy, which exposes the blood vessels and then removes existing thrombi, is another option in invasive arteriosclerosis treatment. In addition, in case of emergency, the closed vessels can also be bypassed by means of a bypass. The constriction is usually bridged by an inserted vein piece. The possibilities of vascular surgery for the treatment of arteriosclerosis are extremely extensive, but ultimately the original functional quality can only ever be restored to a limited extent.

Naturopathy in arteriosclerosis

As mentioned above, diet plays an essential role. The nutritional therapy is therefore of paramount importance in the context of arteriosclerosis treatment. Here, for example, fasting offers a noteworthy naturopathic approach to support the therapy. Herbal medicine (phytotherapy) is often given special consideration in naturopathic arteriosclerosis therapy. Extracts from plants such as ginko, wild garlic, hawthorn, mistletoe, artichoke or rosemary are used here. Prepared and taken as so-called mother tinctures, they are supposed to improve blood circulation, lower blood pressure or counter high blood lipid levels.

Since natural medicine is suspected of a connection between the acid-base balance and the occurrence of arteriosclerosis, some therapists have also adopted measures to counteract the acidification of the organism and thus the deposits in the vessels. In addition, orthomolecular medicine with high dosages of vitamins and minerals can be used. For example, vitamin C and vitamin E are thought to regulate blood lipids and inhibit the formation of blood clots. A similar positive effect is attributed to magnesium, vitamin B6 and coenzyme Q10. Although the different naturopathic treatment options, especially in the case of atherosclerosis in the initial stage, can certainly lead to considerable healing success, even with their help in the advanced stage of the disease can achieve the highest relief of the symptoms. If no treatment successes emerge or the symptoms get even worse, the consultation with a vascular specialist is urgently recommended.

Homeopathy in arteriosclerosis

Homeopathy knows some remedies that can contribute to the treatment. Aurum jodatum, Aurum metallicum, Barium carbonicum and Barium iodatum are mentioned here by way of example. However, the application should always be under the guidance of an experienced homeopath. Schüssler salts are another naturopathic treatment option for atherosclerosis, for example, the Schüssler salts no. 1 Calcium Fluoratum, No. 9 sodium phosphoricum, No. 22 Calcarea carbonica and No. 25. Aurum chloratum natronatum find application. Again, a guide by an experienced therapist is required.

prevention

For the purposes of prevention, the known risk factors such as tobacco consumption, excessive stress or the increased intake of saturated fatty acids should be avoided as much as possible. Also on particularly salty foods should be avoided as a precaution. Instead, a diet rich in fiber and unsaturated fatty acids is recommended. In addition, the antioxidants such as vitamin E or vitamin C, which are contained in different vegetables and fruits, a preventive effect against atherosclerosis attributed. Overall, nutrition is one of the pillars of atherosclerosis prevention. Another is the physical activity. Adequate exercise or sport significantly reduces the risk. Those who eat well and exercise regularly, already makes a significant contribution to reducing his risk of individual atherosclerosis. In order to strengthen the heart, generally recommended is a regularly performed heart training. (Fp)