The whole truth about atherosclerosis 1

What kind of disease is this?

Atherosclerosis (ATHEROSCLEROSIS Latin, from the Greek athere - gruel, sklerosis - compaction) (ICD 10) is a chronic arterial disease that occurs as a result of a violation of fat (lipid) and protein (protein) metabolism. Deposition of cholesterol atheromatous plaques and lipoprotein formations on the walls of blood vessels is observed.

After which sclerosis occurs - a process in which connective tissue grows in the deposits, securing them in place, followed by calcification - deformation of the walls of blood vessels and a decrease in their capacity.

IMPORTANT! According to the WHO definition, atherosclerosis is the accumulation of lipids, complex carbohydrates, fibrous tissue, blood components, deposition of calcium salts and concomitant changes in the middle layer (media) in the arterial wall.

Complex carbohydrates are nothing more than excess sugar, which, collected in cluster structures (polysaccharides), are deposited on the walls of blood vessels. This is the main cause of widespread atherosclerosis, and not the consumption of fatty foods, as has been commonly believed for the last 50 years.

How does the disease occur?

The disease develops under the influence of two factors: vascular and lipid. The bottom line is that pathological deposits of cholesterol, so-called atherosclerotic plaques, form on the walls of blood vessels. They gradually narrow the lumens of the arteries and eventually can completely block them. But for cholesterol to penetrate the vessel wall, certain conditions are needed.

The main one is damage to the inner layer of the artery. Through such damaged tissue, cholesterol penetrates the vascular wall and becomes fixed in it. This is how an atherosclerotic plaque is formed, which grows over time and interferes with proper blood flow.

The second factor in the development of this disease is a violation of lipid (fat) metabolism. The blood contains high and low density lipoproteins. If their concentration in the blood is within normal limits, then plaques do not form. But when the level of low-density lipoproteins increases, the risk of developing atherosclerosis increases sharply.

This disorder of lipid metabolism is caused by:

Age-related changes;
Hormonal imbalances;
Diabetes mellitus;
Excessive consumption of fats;
Lack of coarse fiber in the diet.

The formation of cholesterol plaques is a long process. Clinical signs do not appear immediately. A person usually feels the first symptoms of the disease only in his fifth decade. But there are risk factors that speed up this process. The main one, according to doctors, is lifestyle.

Photo

Read more about photos of common vascular atherosclerosis.

Statistics in Russia

Of the entire share of deaths from diseases of the cardiovascular system in Russia, 40% are due to atherosclerosis. The average age of the patient is 58 years old, predominantly male, has bad habits, and has a sedentary job. Women are exposed to the disease less often, approximately 2 times.

If we compare with statistics from 10 years ago, we get the following data:

The proportion of deaths among patients with CVD was 23%.
The average age of the patient is 76 years.
The percentage of female patients is 4% (18 at the moment).

As you can see, the prognosis is disappointing.

AtherosclerosisD. A. Mantrov

V. RISK FACTORS IN THE DEVELOPMENT OF ATHEROSCLEROSIS

1. Atherosclerotic damage to the coronary vessels underlies the occurrence of coronary heart disease (CHD), therefore, CHD is often called coronary disease, and its prevention is primarily associated with preventing the development and progression of atherosclerosis and its complications. And the consequence can be the most dangerous thing for the life of a modern person - myocardial infarction.

What contributes to the development of atherosclerosis, is it possible to prevent its occurrence and progression?

The search for answers to these questions brought together the efforts of specialists from various branches of clinical and theoretical medicine from many countries around the world. The starting point for their research was the instruction expressed back in the 30s. XX century the largest Soviet scientist, an internationally recognized authority on the study of atherosclerosis, Academician N. N. Anichkov. He considered it necessary to distinguish three groups of factors when analyzing the causes of the onset and progression of atherosclerosis: predisposing to the disease, causing it and contributing to its development.

It has been established that the same factors can cause the development of atherosclerosis and contribute to its progression. It is under their influence that in most cases the genetic predisposition to the disease “wakes up”, which is subsequently realized by its clinical manifestations - various forms of coronary artery disease, damage to the aorta and its branches, cerebral vessels, arteries of the lower extremities. The younger the age of influence on the body of “risk factors” for the occurrence of atherosclerosis begins and the more intense it is, the earlier and to a greater extent vessels of various localizations are affected.

Currently, the basis of primary prevention (preventing the development of the disease) of atherosclerosis, and therefore ischemic heart disease, is the concept of risk factors. This term refers to lifestyle habits or any congenital characteristics that increase the risk of the disease. The more risk factors a person has, the more likely they are to get sick, and vice versa. By studying large populations of people in countries differing in natural conditions, degree of industrialization, lifestyle, and nutrition, risk factors for atherosclerosis and coronary artery disease were identified. They can be divided into two groups: factors that cannot be changed, and factors that can be influenced.

Risk factors for ischemic heart disease and atherosclerosis that cannot be changed include gender, age, and heredity. It has been established that men suffer from ischemic heart disease more often and the disease develops in them at a younger age than in women. In recent years, there has been an increase in the incidence of IHD in women, which is mainly associated with lifestyle changes and the acquisition of bad habits: smoking, low physical activity, excess body weight, but still women suffer from IHD and atherosclerosis less often than men. Everyone is well aware that the risk of developing atherosclerosis increases with age for both men and women. If immediate relatives suffer from coronary artery disease, especially before the age of 60, then there is an unfavorable heredity, these persons should be especially attentive to their health and strive to avoid other risk factors.

Among the risk factors that can be modified, the most important are high blood cholesterol (hypercholesterolemia), cigarette smoking, and high blood pressure (hypertension). These are called the main risk factors. There is a lot of scientific evidence to suggest that there is a causal relationship between these risk factors and the development of atherosclerosis and coronary artery disease. There are a number of other risk factors, the influence of which is less clear than those indicated above. These are diabetes mellitus, low physical activity, excess body weight, and increased levels of uric acid in the blood. Let's take a closer look at each of these risk factors.

2. High cholesterol levels in the blood, impaired fat (lipid) metabolism. Cholesterol belongs to the group of fats; it is necessary for the normal functioning of the body, but its high level in the blood contributes to the development of atherosclerosis. Cholesterol circulates in the blood as part of fat-protein particles - lipoproteins, the importance of which in the development of atherosclerosis was discussed above. A certain level of cholesterol in the blood is maintained due to cholesterol supplied with food and its synthesis in the body.

Currently, a large amount of indisputable data has been accumulated on the connection between elevated blood cholesterol levels and the risk of developing atherosclerosis, and therefore coronary artery disease. They can be summarized as follows:

1) experiments on animals have shown that feeding them food high in cholesterol leads to the development of atherosclerosis;

2) epidemiological studies of population groups differing in blood cholesterol levels have revealed varying degrees of prevalence of IHD in them;

3) in persons suffering from coronary artery disease, increased cholesterol levels in the blood are more common;

4) in persons with a genetically determined high level of cholesterol in the blood (familial hypercholesterolemia), atherosclerosis and coronary artery disease almost always develop prematurely, i.e. in this situation we seem to have an experiment in nature.

There is a linear relationship between the level of cholesterol in the blood and the development of coronary heart disease, i.e., the higher the cholesterol level, the greater the risk of the disease. The limit of normal blood cholesterol level identified in practice is arbitrary. Blood cholesterol levels of up to 6.72 mmol/l (260 mg%) and below are considered normal. Large international studies show that among population groups with similar levels of cholesterol in the blood, IHD is relatively rare (for example, in the countries of the Mediterranean basin).

According to modern ideas about the mechanisms of development of atherosclerosis and coronary artery disease, not only the total cholesterol content in the blood matters, but also which group of lipoproteins it is associated with. As mentioned earlier, the risk of developing coronary artery disease is directly related to low-density lipoproteins and inversely related to high-density lipoproteins. Changes in individual levels of these lipoproteins and their ratio provide more accurate information about the risk of developing coronary artery disease. The level of cholesterol in the blood depends mainly on the composition of food, although the genetically determined ability of the body to synthesize cholesterol also has an undoubted influence. There is usually a clear relationship between saturated fat and cholesterol intake and blood cholesterol levels. A change in diet is also accompanied by a change in blood cholesterol levels. A number of formulas have been developed that can be used to predict how a change in cholesterol content in food by 100 g can change its content in the blood by 0.129-0.165 mmol/l (5-6 mg%). However, these formulas only take into account dietary cholesterol and do not take into account cholesterol synthesized in the body. Different types of fat have different effects on blood cholesterol levels. Saturated fatty acids have the most pronounced ability to increase cholesterol levels, while unsaturated fatty acids have the opposite effect, that is, they help reduce cholesterol in the blood. Thus, cholesterol and saturated fatty acids coming from food are the main substances that contribute to increased cholesterol levels in the blood and, consequently, the development of atherosclerosis. For each individual person, the level of cholesterol in the blood depends on the amount it comes from food and the genetically determined ability of the body to synthesize it.

Preventing the occurrence of atherosclerosis or slowing its progression is facilitated by the normalization of lipid metabolism, which reduces the deposition of cholesterol in the walls of blood vessels. Patients with severe atherosclerotic vascular lesions are characterized by excess cholesterol not only in the blood, but also in the cells. In atherosclerotic plaques, the content of cholesterol compounds (in particular, cholesteryl esters) is found to be several times higher than their concentration in the blood, from which they penetrate into the vascular wall.

It is an undeniable fact that eliminating hypercholesterolemia (high cholesterol levels) and some other dyslipidemias (fat metabolism disorders) significantly reduces the risk of atherosclerosis and the development of coronary heart disease.

3. As indicated, arterial hypertension is considered the main factor in the development of atherosclerosis and its complications.

The danger of hypertension is that many people are asymptomatic and feel healthy. Doctors have this expression - “the law of halves.” It means that of all people with arterial hypertension, half do not know about their disease, of those who know, only half are treated, and of those who are treated, half are treated effectively, that is, they achieve normalization of blood pressure. This situation occurs everywhere unless special efforts are made to actively identify and treat individuals with hypertension.

A prolonged increase in blood pressure has a damaging effect on many organs and systems of the human body, but the heart, brain, kidneys, and eyes suffer the most. With arterial hypertension, the heart is forced to constantly work with increased stress. Gradually, it “wears out” and heart failure develops, manifested by shortness of breath, first during physical exertion, and then at rest. High blood pressure contributes to the development of damage in blood vessels. They become less elastic, “brittle”, and atherosclerosis develops faster in them. The vessels of the brain are especially often affected, resulting in strokes of the vessels of the eyes, where hemorrhages often occur, leading to loss of vision, and in severe cases to blindness. American scientists have calculated that a man aged 35 years with a blood pressure of 120/80 mm Hg. Art., the expected life expectancy is 41.5 years, then with a blood pressure of 140/95 mm Hg. Art. - 37.5 years, and with a blood pressure of 150/100 mm Hg. Art. - 25 years, i.e. even a moderate increase in blood pressure significantly reduces life expectancy.

It has been proven that arterial hypertension in men aged 40–59 years increases the risk of developing coronary artery disease by 4.2 times, and the risk of death from diseases caused by atherosclerosis by 4.5 times.

In studies of patients with various stages of hypertension and in experiments on animals, it was established that the triggering mechanism is a change in the structures and properties of the vascular wall that occurs against the background of a long-term increase in vascular tone under the influence of so-called pressor substances, the leading role among which is given to osetecholamines (adrenal hormones) . Under these conditions, damage to the inner surface of the vascular wall of small arteries develops, an increase in its permeability, which is accompanied by the impregnation of its structures with cholesterol and other lipids, and excessive proliferation of cells in the vascular wall. The latter is facilitated by the accumulation of platelets (red blood platelets) of blood cells in places of damage, forming a kind of “patches” in places of vascular microdefects. For the same purpose, they produce substances that enhance the proliferation of cell structures in the walls of blood vessels, increase the degree of their contraction, and activate blood clotting processes.

However, such a complex action of platelets, aimed at eliminating damage to the vascular wall, also has its negative side. It turns out to be excessive and cannot stop on its own in time, since the body retains the effect of the “trigger mechanism” - the initial increase in vascular tone in a patient with hypertension.

Only if it is eliminated in a timely manner, i.e., with the early initiation of adequate treatment for high blood pressure, can the development of sclerotic changes in the vessels be avoided. The longer a person suffers from hypertension, the more changes occur in the blood vessels and the less hope there is for their reversibility, even with ongoing therapy. That is why measures to prevent arterial hypertension taken from a young age, timely, i.e., the earliest possible start of its treatment, is the key to a healthy cardiovascular system in adulthood.

In recent years, cardiologists have been especially persistent in looking for ways to primary prevent arterial hypertension, i.e., prevent the disease. For further prevention, it is necessary to know the causes or factors contributing to the development of the disease. In 90–95% of cases, the cause of arterial hypertension cannot be determined. This type of hypertension is called primary, essential, or hypertension. In some diseases, hypertension is one of the symptoms of the disease. This type of hypertension is called secondary or symptomatic. In these cases, cure of the underlying disease usually leads to normalization of blood pressure. These include some adrenal tumors, kidney disease, and narrowing of the renal arteries. Taking contraceptive medications can increase blood pressure in young women. Although the cause of the development of hypertension is not yet completely clear, factors that contribute to its occurrence have been identified, by influencing which it is possible to prevent hypertension. These factors can be divided into genetic and environmental; the possibility of a mutually reinforcing influence of these two types of factors cannot be ruled out. Scientific evidence confirms the role of heredity in the development of hypertension. This similarity in blood pressure levels is observed in adult first-degree relatives and identical twins.

End of introductory fragment.

Pathogenesis: what is the process?

It is also called atherogenesis (pathogenesis). First, the process of “toxins” entering the vascular wall takes place, then the process of releasing lipoproteins and leukocytes from it, cell death, and redistribution of intercellular substances. The final stage is deformation of the walls and proliferation of blood vessels.

Let's look at each stage in detail

Accumulation and modification of lipoproteins

Normally, the arterial wall consists of a single-cell endothelial layer, under which are located smooth muscle cells located in the intercellular substance. The first signs of the disease are lipid stains. Their appearance is associated with local deposition of lipoproteins. Being on the walls of blood vessels, lipoproteins enter into chemical reactions, such as:

Oxidation, with the formation of hydroperoxide, the excess of which leads to the rupture of peptide bonds and the combination of the breakdown products of protein metabolism with the breakdown products of fatty acids.
Non-enzymatic glycosylation is a process that accompanies patients with diabetes, promoting hyperglycemia (increased blood sugar levels), which accelerates the process of atherogenesis.

Migration of leukocytes and formation of xanthoma cells

The migration of lipoproteins is ensured by adhesion receptors, which are located on the walls of the endothelium. After adhesion (absorption), leukocytes pass through the wall and accumulate creating a xanthoma (foamy) cell, in common parlance - a plaque.

Proanterogenic and antiatherogenic factors

In the process of absorption of lipoproteins modified by the previous stage, growth factors are released that promote the development of xanthoma cells (proanterogenic factor).

Plaque proliferation

The main reason for this process is the action of low molecular weight neurotransmitters, such as, for example, serotonin and dopamine. They slightly increase the speed and intensity of all body processes. In this case, their action does more harm than good, only because the receptors responsible for the signal to remove plaques are blocked by these very deposits and the signal does not pass through.

Expert opinion

Zemlyanukhina Tatyana Vyacheslavovna

Ambulance and emergency paramedic at the Clinical Emergency Hospital #7 in Volgograd.

Ask an expert

I cannot completely agree with the information provided. The harm of serotonin and dopamine is very controversial and in the early stages of plaque formation and development, these neurotransmitters do not pose any danger. Under their influence, the plaque can only dissolve faster. The body begins to harm itself only after the stage of germination of blood vessels into blood vessels.

Macroscopic changes

Using instrumental research methods, it is possible to determine the condition of the wall, as well as the level of degenerative changes.

The following stages are distinguished:

Fatty streak stage or early manifestation of the disease. Yellow spots that are located on the intima, namely in the inner membrane, can increase with age and merge into conglomerates. The muscle fibers that are in the intima absorb them and turn into foam cells. This stage is an accumulation of microphages and muscle fibers.
Stage of fibrous plaque. It is characterized by the location of the formation in the intima of the vessel, which begins to grow eccentrically. This growth provides an overlapping diameter for the passage of blood. The plaque consists of a core, based on bound cholesterol. The capsule consists of endothelial cells, microphages, and fibrous fibers.
Stage of complex disorders. This is the transition to clinical manifestations. With the help of specific factors, the fibrous plaque begins to crack and platelets stick to it - this increases the risk of blood clot formation.

Microscopic pathologies

When examining at the histological level, the following stages of morphological changes are distinguished:

Pre-lipid. It is characterized by increased permeability of the walls of blood vessels and their swelling. Due to the described processes, fibrinogen, blood protein and glycosaminoglycan are deposited in the intima. Thus, disturbances in metabolic processes are observed.
Lipoid. Metabolic disorders progress. At this point, it is easy to detect fatty streaks and spots. Thickening of the intima is observed due to active focal infiltration of cholesterol and lipoproteins.
Liposclerosis. It is characterized by the appearance of a plaque that begins to actively develop at the site of the breakdown of protein elements. Along the periphery, angiogenesis or the formation of blood vessels occurs, which causes an increased supply of blood plasma proteins.
Atheromatosis. Once the plaque has formed, it will begin to break down. At the site of the lesion, you can see detritus, which contains cholesterol crystals. The plaque contains many lipids and blood vessels, lymphocytes and plasma cells. During this period, the muscular layer becomes very thin, the fibers atrophy and a hematoma appears as a result of the destruction of blood vessels.
Stages of expression. When plaques are destroyed, an ulcer with jagged edges is formed, which sinks to the bottom of the artery. Such a defect is often covered by thrombotic masses due to the activation of formed bodies and blood clotting factors.
Atherocalcinosis. It represents the formation of calcium salts into the formed thrombus. At the molecular level, there is an accumulation of glutamic acid, which contains carboxyl groups.

How to slow down the progression?

Lifestyle changes can slow the progression of atherosclerosis:

Quit smoking to avoid damaging your arteries.
Exercise several times a week. Try to walk more, climb stairs, breathe air, and also do a lot of other exercises that are not contraindicated for health reasons.
Eat healthy foods.
A balanced diet based on fruits, grains and vegetables is important. You need to stick to your weight and avoid sudden weight loss and weight gain.
Reduce your stress levels. Relax more.
Monitor your heart function. This way you can avoid any complications.

Risk factors and prevention of cardiovascular diseases

Despite the variety of serious diseases relevant to the modern world, cardiovascular diseases are still the leading cause of death in the world. Heart disease accompanies any type of illness that affects the cardiovascular system. These are mainly heart diseases, vascular diseases of the brain and kidneys, as well as diseases of peripheral arteries. The causes of heart disease are varied, but the most common are atherosclerosis and hypertension. In addition, with age, a number of physiological and morphological changes occur that impair the function of the heart and blood vessels, and subsequently lead to an increased risk of heart disease, even in healthy people without symptoms.

Risk factors for developing cardiovascular diseases

Risk factors can be removable and non-removable. Avoidable are risk factors that can be eliminated in one way or another, and NOT avoidable are risk factors that (unfortunately) cannot be eliminated.

Below I will list the risk factors, and you count - how many of them do you have? The more risk factors you have, the more likely you are to develop cardiovascular disease, and if you have diseases, to develop complications.

Unavoidable risk factors:

Gender and age: the risk is higher in men than in women; with age, the differences decrease (at the age of 35–70 years, men have a 30% higher risk of death from stroke, and 2–3 times higher risk of death from ischemic heart disease than women. At the age of 75 years, the risk of death from CVD is approximately the same in men and women Men over 55 years of age and women over 65 years of age are more susceptible to cardiovascular diseases.
Menopause. Menopausal women have a higher risk of cardiovascular disease.
Heredity. Heart disease in your direct relatives indicates a higher likelihood of developing similar diseases in you.
Geographic region of residence: high incidence of stroke and ischemic heart disease in Russia, Eastern Europe, and the Baltic countries.
Damage to target organs (heart, brain, kidneys, retina, peripheral vessels). The presence of irreversible diseases of the listed organs significantly increases the risk of cardiovascular disaster.
Diabetes. Diabetes mellitus is currently classified as a target organ disease. Signs of diabetes: thirst, dry mouth, high fluid intake, frequent (painless) and copious urination.

Avoidable risk factors:

Smoking was named first because it is the easiest to eliminate: smoking increases the risk of heart disease by 1.5 times; increases the risk of atherosclerosis, obliterating vascular diseases, and cancer; increases LDL cholesterol (the worst for the heart); increases blood pressure both in patients with hypertension and in people with normal blood pressure.
Hypercholesterolemia (total cholesterol > 5.2 mol/l).
Dyslipidemia (changes in the ratio of levels of different cholesterol fractions):
Increased systolic (upper) blood pressure > 140 mmHg.
Increased diastolic (lower, “heart”) blood pressure > 90 mm Hg.
Increased salt intake.
Obesity: with a body mass index of 25 - 29 (obesity 2 degrees) the risk of coronary heart disease is 70% higher, with a BMI > 30 (obesity 3 degrees) - 300% higher; At the same body weight, the risk of coronary artery disease, stroke and death increases with increasing waist/hip ratio.
Alcohol abuse.
Physical inactivity (daily exercise of light or moderate intensity for 20 minutes reduces the risk of death from coronary artery disease by 30%).
Stress.
Increased blood sugar.
In case of impaired renal function, when protein begins to leak through the kidneys, as well as hypercreatininemia (chronic renal failure) - a later criterion for kidney damage, when the kidneys cannot cope with their function.
Pulse blood pressure (the difference between systolic and diastolic) is more than 60 mmHg, high blood pressure variability (range of values within 24 hours), insufficient decrease or increase in blood pressure at night. That is, there should be no sudden surges in pressure, and at night the blood pressure should be lower than during the day.
Tachycardia, i.e. rapid pulse or heartbeat.
Sleep apnea syndrome. This includes snoring and short-term pauses in breathing during sleep.
Socioeconomic status (the lower the social status, the higher the risk of cardiovascular disease).
Stress.

PREVENTION

Quit smoking and protect yourself from secondhand smoke.

Firstly, smoking is one of the main causes of atherosclerosis, arterial hypertension, coronary heart disease and stroke. And, on the contrary, stopping smoking leads to a reduction in the risk of the disease by exactly half. Secondly, cigarette smoke contains not only nicotine, but also carcinogenic tars that affect the human cardiovascular system. The characteristic fact is that passive smoking is just as destructive as active smoking.

Don't abuse alcohol.

Alcohol in minimal quantities (no more than 20 ml of ethanol for women and no more than 30 ml of ethanol for men per day) thins the blood and has a beneficial effect on the cardiovascular system, but if the norm is exceeded, its effect becomes sharply negative.

Control your weight.

People who are overweight and especially obese are 2–3 times more likely to develop cardiovascular diseases, and they are more likely to develop complications. Control your weight and waist circumference.

Eat right.

Moderate consumption of meat (especially red), a sufficient amount of fish (minimum 300 g per week), consumption of vegetables and fruits, refusal or limitation of fatty, fried, smoked foods - these are simple and effective measures that will not only allow you to keep your body in good shape, but will also significantly reduce the risk of cardiovascular diseases. Monitor your blood cholesterol levels and remember that they can be normalized with proper healthy eating.

Move more.

The normal and necessary level of physical activity is 150 minutes of any physical activity per week - this is a prerequisite for successful prevention of cardiovascular diseases.

Learn to control stress.

Chronic lack of sleep, as well as constant psychological stress, weaken the immune system, exhaust a person, and cause arrhythmia and disturbances in cardiac activity in general. Healthy sleep and a philosophical attitude to life, on the contrary, significantly increase your chances of avoiding cardiovascular diseases.

Diabetes control.

If you have diabetes, strictly follow all the recommendations of your doctor, monitor your blood sugar levels and be aware of any changes in your health.

Monitoring blood pressure levels.

Monitor your blood pressure and, if you have any disorders (hypertension, hypotension), be sure to follow all the recommendations of your doctor.

ADVICE OF A CARDIOLOGIST:

ALGORITHM OF ACTIONS FOR HEART PAIN.

1. Pain in the heart area is one of the most common reasons why people seek emergency medical care. These pains attract attention and cause concern more than many others.

2. It is known that half of the adverse outcomes in various forms of acute coronary syndrome (ACS is a concept that unites a number of severe and life-threatening conditions at any moment) occur in the first hours of the disease, so time in this case is a dangerous enemy, and the greatest efforts must be made be targeted for early diagnosis and treatment.

3. The positive effect in the treatment of ACS directly depends on the time of seeking medical help. In this case, the signs of a heart attack may be reversible and will not significantly affect the functional state of the heart in the future.

4. The onset of myocardial infarction often has a typical character - the pain seems to burn, press and squeeze, occurs in the area behind the sternum and can radiate to the left arm. Often pain is accompanied by severe anxiety and fear: a person tries to find a place for himself, cannot fully understand what is happening. In the case of initial forms of the disease, pain subsides within one to five minutes after taking the drug. If the pain does not disappear after this period of time, it means that this is a signal that the disease has become more severe, and, therefore, there is a high chance of developing a myocardial infarction.

5. During an attack, the following measures are recommended for urgent pain relief:

create physical and psycho-emotional peace for the patient: lie down, sit down, or stop if chest pain appears during exercise;
It is urgent to take 1 tablet of nitroglycerin under the tongue.
The analgesic effect of nitroglycerin usually occurs within 1–5 minutes. To stop an attack, 1-2 tablets of nitroglycerin are enough;
you need to take ½ tablet of acetylsalicylic acid;
if the attack is prolonged (lasts 10–15 minutes) and repeated doses of nitroglycerin are ineffective, you must immediately call an ambulance - this cannot be tolerated!

6. If the pain lasts more than 10–15 minutes, it cannot be tolerated. It is urgent to call an ambulance. The outcome of treatment depends on how early the patient consulted a doctor. Nowadays, many patients tend to delay this. Some believe that the pain is associated with osteochondrosis, others - with bronchitis, smoking, etc. Such underestimation of the symptoms of the disease often causes late treatment, and therefore a late start of treatment.

ATTENTION! A patient with a heart attack is strictly forbidden to get up, walk, smoke or eat until the doctor’s special permission; Do not take Aspirin (Acetylsalicylic acid) if you are intolerant to it (allergic reactions), as well as with a clear and severe exacerbation of gastric and duodenal ulcers; Nitroglycerin should not be taken if there is severe weakness, sweating, as well as severe headache, dizziness, acute impairment of vision, speech or coordination.

ACUTE CEREBRAL CIRCULATION IMPAIRMENT (ACI).

Main signs (symptoms):

Numbness, weakness, “disobedience” or paralysis (immobility) of an arm, leg, half of the body, distortion of the face and drooling on one side;
Speech disorders (difficulty in choosing the right words, understanding speech and reading, slurred and unclear speech, up to complete loss of speech);
Impaired or loss of vision, double vision, difficulty focusing;
Impaired balance and coordination of movements (feelings of “swaying, sinking, body rotation, dizziness”, unsteady gait up to falling);
Unusually severe headache (often after stress or physical exertion);
Confusion or loss of consciousness, uncontrollable urination or bowel movements.

If any of these signs suddenly appear, call an ambulance immediately, even if these manifestations of the disease were observed for only a few minutes.

Algorithm of actions before the arrival of an emergency medical team.

If stroke occurs, it is necessary to follow the instructions received earlier from the attending physician; if there were no such instructions, proceed according to the following algorithm:

If the patient is unconscious, place him on his side, remove removable dentures (food debris, vomit) from the mouth, make sure that the patient is breathing.
If the victim is conscious, help him take a comfortable sitting or semi-sitting position in a chair or on a bed, placing pillows under his back. Provide fresh air. Unbutton your shirt collar, belt or waistband, and remove tight clothing.
Take 2 Glycine tablets and place them under the patient’s tongue.
Measure the patient's body temperature. If it is 38 degrees Celsius or more, give the patient 1g of Paracetamol (2 tablets of 0.5 g, chew, swallow), (if Paracetamol is not available, do not give other antipyretic drugs!).
Place ice or freezer food in waterproof bags wrapped in a towel on your forehead and head.
If the patient has previously taken medications that lower blood cholesterol levels from the statin group (Simvastatin, Lovastatin, Fluvastatin, Pravastatin, Atorvastatin), give the patient his usual daily dose and take the drug with you to the hospital.
If the arrival of emergency medical services is delayed, measure the patient's blood pressure and if its upper level exceeds 220 mm Hg, give the patient a blood pressure lowering drug that he was taking previously.
If the victim has difficulty swallowing and saliva drips from his mouth, tilt his head towards the weaker side of the body and blot the dripping saliva with clean napkins.
If the victim is unable to speak or has slurred speech, reassure and reassure him that the condition is temporary. Hold his hand on the non-paralyzed side, stop him from trying to talk, and don't ask questions that require an answer.
Remember that although the victim cannot speak, he is aware of what is happening and hears everything that is said around him. Next, before the arrival of the emergency medical team, the patient must place 1-2 Glycine tablets under the tongue at intervals of 5-10 minutes (in total, no more than 10 tablets).

REMEMBER!

closed cardiac massage performed in the first 60–120 seconds after sudden cardiac arrest allows up to 50% of patients to be brought back to life;
Only emergency medical care called for the first time 10 minutes from the onset of a heart attack or stroke allows the full use of modern highly effective methods of hospital treatment and many times reduce mortality from these diseases;
Acetylsalicylic acid (Aspirin) and Nitroglycerin taken for the first time for 5 minutes can prevent the development of myocardial infarction and significantly reduce mortality from it;
state of alcoholic intoxication is not a reason for delaying calling an ambulance in the event of a heart attack and stroke - about 30% of people who died suddenly at home were intoxicated.

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Causes

Unchangeable reasons

Unchangeable causes of atherosclerosis are those that have no medical impact. These include the following:

Age. Once a person reaches a certain age, the chances of developing this disease become too great. Everyone who has crossed a certain age threshold observes changes in blood vessels. The risk of developing atherosclerosis increases between the ages of 45 and 50 years.
Floor. Men are more likely to get this disease than women. But when a person is over 50 years old, the percentage of the disease in relation to men and women becomes the same. This is due to the onset of menopause in women and the disappearance of the protective role of estrogen in men.
Genetic predisposition. People whose relatives suffer from atherosclerosis in any form are at particular risk.

Variable reasons

Modifiable causes of atherosclerosis are those that can be influenced with medication or lifestyle changes. Variable factors include the following:

Smoking, drinking large quantities of alcohol.
Poor nutrition, hypertension.
Obesity, diabetes.
Dyslipidemia, physical inactivity.
Infections.

The factors presented have the following effects on blood vessels:

Smoking and alcohol have a negative effect. These factors increase the risk of developing the disease several times. If the diet is incorrect and the diet contains a large amount of fatty foods, this can lead to the development of atherosclerosis.
Arterial hypertension is the main ally of the disease. With high blood pressure, the arterial walls are even more damaged. Dangerous pressure is more than 140/90 mm.
Obesity can cause atherosclerosis. Women with a waist larger than 88 cm and men with a waist larger than 102 cm are at risk.
Diabetes mellitus can increase the risk of developing the disease by 4-7 times. It is accompanied by metabolic disorders in the human body.
Dyslipidemia is a disease associated with impaired fat metabolism in the human body. With elevated cholesterol levels, this disease plays a major role, as it leads to heart problems.
A sedentary lifestyle or physical inactivity will lead to metabolic disorders and an increased risk of developing diabetes and sclerosis.
Infections. Studies conducted relatively recently have shown that the main cause of the development of atherosclerosis is chlamydial infection and cytomegalovirus. Many patients have high levels of antibodies.

In this issue I will discuss an issue that concerns every person. Unfortunately, many, even if they have heard about it, do not fully realize what a threat it is to their lives, because it occurs without any sensations. This is atherosclerosis . A disease that no medical organization in the world, not even the World Health Organization (WHO), can cure.

It's worth starting with statistics. Let's look at the main causes of death in our country for the 2013 calendar year:

Diseases of the circulatory system (cardiovascular system) – 999 thousand. (61%)!!!
Neoplasms (tumors) – 289 thousand (18%)
External causes (transport accidents, accidental alcohol poisoning, suicides, murders) – 172 thousand (10%)
Diseases of the digestive system – 87.5 thousand (5%)
Respiratory diseases – 72.1 thousand (4%)
Some infectious and parasitic diseases – 30.4 thousand (2%)

The first place is occupied by diseases of the circulatory system. What kind of diseases are these? You've probably heard them:

Coronary heart disease - IHD (this includes myocardial infarction (the heart muscle partially dies), angina pectoris (the heart seizes), various arrhythmias (the heart beats in a completely wrong rhythm, which can be fatal), conditions after a heart attack, and others)
Strokes (can be ischemic - when blood does not flow through a vessel to the brain, as well as hemorrhagic - when a vessel ruptures and hemorrhages into the brain, resulting in massive death of brain cells)
Obliterating atherosclerosis of the arteries (there is poor blood supply to the organ through the artery as a result of its narrowing. Often observed on the legs, when a person ends up having difficulty walking)
Other more rare diseases.

“Thanks to” these diseases, more than half of all people who leave our mortal world die. This is just CATASTROPHICALLY A LOT! In other countries the statistics are similar, there is no big difference. So many people don’t even die now in all the wars and terrorist attacks that are always so annoyingly shown on TV.

Now think carefully. How many cases do you know of when someone had a heart attack? Or maybe he had a stroke? I am sure that you have such situations in your memory, and more than one.

If you decide to delve deeper into your understanding of this problem, you will find in the medical literature an interesting fact about the causes of these diseases (in such books they call it etiology). ATHEROSCLEROSIS is the most common cause of diseases of the cardiovascular system. That is why I decided to talk in more detail about this constantly “hiding beast”, which can be called your ENEMY No. 1. More than HALF of the people in the world will die from atherosclerosis, and even more will be disabled for life. The question is: do you want to be in this half? If not, then we'll figure it out. Let us develop PRACTICAL recommendations to combat this epidemic of humanity.

Atherosclerosis is a chronic disease, which is based on the formation of plaques on the arteries, which leads to their narrowing and a decrease in the flow of blood through them to the organs with all the ensuing consequences.

What is the cause of this disease? Medical science has not yet reached the heights to name one reason. They believe that a major role in development is played by:

Violation of lipid (fat) metabolism in the body.
Increased blood pressure in the vessels.
Heredity.

Let's try to understand the process of its development. Then it will be clear how to deal with this.

The onset of the disease occurs literally from birth. The child already has lipid stains (yellowish spots on the arteries). But this is not scary, since the structure of the vessel does not suffer. The process actively starts around the age of 9-11. Poor nutrition and genetic predisposition lead to high levels of lipid fats (to be precise, lipoprotein complexes, which we will talk about in the next issue) in the blood. This leads to the fact that the cells lining the artery from the inside die due to oxygen starvation (endotheliocytes).

A weak asymptomatic inflammatory process occurs. Lipids, which are already abundant in the blood, eventually rush into the damaged “gap” of the vessel, which leads to the deposition of fats in its wall. A LIPID PLAQUE is formed . It does not yet narrow the lumen of the artery. But that's it for now.

This stage is already present at 25 years of age. Moreover, on the largest vessel in our body, the AORTE, 30-50% of the lumen is already in plaques. And starting from 30 to 40 years of age, a fibrous plaque develops.

Fibrosis is the process of proliferation of connective tissue in a vessel. This is a gradual process. As a result, the vessel loses its ELASTICITY , calcium salts are deposited in the plaque, and it becomes stone-like. But this is not so bad - the lumen of the vessel becomes smaller, the blood supply to the tissue may be about to stop! a THROMBUS may form , which will block the lumen, and fatal diseases will occur - myocardial infarction, stroke.

The danger also lies in the fact that the vessels of the heart, brain and aorta are more often affected.

For clarity, I will give an example. Imagine a state with its economy. In order for all its structures to function, good quality roads are needed. But then, the main road to one city collapsed. How long will this city remain normal? NO! It will lack fuel for heating stations, food for the population, gasoline for transport, etc. And in the end, the city will perish. It's the same with our arteries. Atherosclerosis completely blocks the paths of the “economy” of our country - the body. Blood does not flow to the city “heart” - a HEART ACT occurs, “ brain ” - a STROKE occurs, because there are no resources - oxygen and nutrients. As a rule, complications develop after 50-60 years, but can appear earlier.

Okay, how can you STOP this process? Unfortunately, this will not be possible to do completely. But you can slow down its speed many times.

Doctors identify so-called risk factors - these are conditions that will accelerate the process of plaque deposition on the arteries. Let's list them:

Dyslipoproteinemia (imbalance in lipoprotein complexes, which manifests itself in an increase in “atherogenic” fractions. More on this in the next issue. These are low-density lipoprotein fractions).
Hypercholesterolemia (increased cholesterol levels in the blood) - enhances the process of fat deposition in blood vessels.
Nutrition (eating fried foods, fast food, large amounts of sweet foods leads to obesity and increased cholesterol levels in the blood, and a large amount of salt leads to high blood pressure - see below).
Arterial hypertension (hypertension, high blood pressure). The more blood presses on the arteries, the MORE the internal lining is damaged, which leads to an acceleration of the process.
Obesity (yes, obese people really live shorter lives. This is due to the fact that there is a lot of cholesterol in the blood, and fat metabolism is also disrupted, which leads to an increase in “atherogenic fractions”).
Diabetes mellitus (with this disease, cholesterol is also increased)
A sedentary lifestyle – physical inactivity (the less a person moves, the greater the risk of obesity and high blood pressure).
And the other remaining 242 risk factors identified by the World Health Organization.

I would highlight the most important risk factor – nutrition. After all, all this, as a rule, does not exist in childhood. And atherosclerosis still progresses. We eat a lot of harmful and alien products - a lot of sweet foods (confectionery, chocolate, sugar, etc.), fatty foods (including fried foods), and salty foods . Next time you're in the supermarket, think about how much ABSOLUTELY unnecessary stuff people buy because it's delicious. And you need to eat BOILED, STEAMED . This is the most favorable culinary treatment.

As for salt, it has been proven that it increases blood pressure. is not to completely add salt to the food (food products already have enough salt for our body). This is unusual for the first 2 weeks. Then you yourself will be surprised at what over-salted food is sold in stores.

Don’t forget that daily physical activity is necessary – we recommend walking at least 30 minutes a day.

I will tell you in more detail about the first 2 points in the next issue (how to control cholesterol levels in the blood, what tests need to be taken, what this or that indicator indicates, correction medications).

So, friend, I hope the information was useful, and I was able to get through to you that you need to take care of your health now. Atherosclerosis is a very clear threat. Unfortunately, the majority will not follow my recommendations, because the disease is asymptomatic. But among us, people, if nothing hurts or bothers us, then everything is fine. Although this may not be true. I hope that you are one of those smart people who care about their health! Be healthy!

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Theories of origin and development mechanism

Lipid theory

Talks about genetic conditioning. In other words, the innate genetic lipid profile contains incorrect information, based on which the disease progresses slowly. Thus, only time determines when a person begins to feel all its symptoms.

Parasitic theory

It says that parasites living in the human body disrupt the natural functions of the body and metabolism, and the decay products of their vital activity contribute not only to the deposition of plaques, but also to the formation of cancer.

Factors accelerating the development of the disease

Medicine identifies several such risk factors. Here are the main ones:

Heredity;
Hormonal imbalance;
Poor nutrition;
Obesity;
Smoking;
Sedentary lifestyle;
Excessive alcohol consumption;
High blood pressure;
Frequent stress.

Let's look at these factors in more detail.

Heredity

Doctors have concluded that genetic predisposition plays a significant role in the development of atherosclerosis. People whose relatives have a similar pathology have a much higher risk of developing cholesterol plaques.

Smoking

One of the dangerous factors that leads to atherosclerosis. Tobacco contains nicotine, which increases blood pressure, increases heart rate, and increases the heart muscle's need for oxygen. Smoking disrupts the heart rhythm, causes vasospasm, disrupts blood flow, and promotes the formation of blood clots.

Cigarette smoke contains carbon monoxide, which prevents the organs from being fully supplied with oxygen. The brain and heart suffer the most from this. When tobacco burns, substances are formed that damage the vascular walls. This bad habit aggravates the effect of other negative risk factors for this serious disease.

Stress

Stress is any impact on the body to which it responds with a powerful release of hormones into the blood. They increase the mental and physical capabilities of the body. This is usually beneficial. But long-term, incessant stress leads to the development of a number of diseases.

Frequent emotional stress is as important for the progression of atherosclerosis as smoking.

A common reaction to a stressful situation is a powerful release of adrenaline into the blood. This helps the body mobilize all its strength to overcome the perceived danger. The blood vessels of the brain dilate, its nutrition increases. Information is perceived and processed faster. Blood pressure rises, pulse quickens, metabolism accelerates. This is the first reaction to stress.

At a moment of emotional stress, norepinephrine also enters the bloodstream along with adrenaline. It sharply constricts the blood vessels, and the pressure rises even more. As a result, the walls of the arteries are damaged, and cholesterol penetrates into them. This gives impetus to the development of atherosclerosis.

Long-term stress, especially in combination with obesity and smoking, has a detrimental effect on the cardiovascular system. It dramatically increases the risk of heart attack and stroke.

Nutrition

Products that are included in the daily diet can both accelerate the pathological process and slow down the development of the disease. If a person consumes large amounts of saturated fat every day, then the concentration of low-density lipoproteins in his blood increases. Cholesterol, which is part of them, envelops the vascular walls. As a result, favorable conditions arise for the formation of atherosclerotic plaques.

The risk group includes lovers of sweets: cakes, pastries, pastries.

Cholesterol is also found in large quantities in other products of animal origin:

Sale;
Butter;
Eggs;
Fatty meat;
Dairy cream.

This does not mean that all these foods should be completely excluded from your daily diet. They just need to be consumed in moderation. After all, cholesterol is also vital for our body. It is a building material for a number of vitamins and hormones.

Hormonal changes

Doctors know that in women the cause of the development of atherosclerosis is often menopause. Exacerbation of the disease

occurs due to a decrease in estrogen levels. It is this hormone that protects the female body from vascular damage.

It maintains their elasticity and prevents damage to their walls. In men, a similar function is assigned to testosterone. But its production needs to be stimulated by moderate physical activity.

Reduced physical activity increases the risk of developing atherosclerosis in the stronger sex.

Alcohol abuse

Another factor that leads to the progression of the disease. Many people mistakenly believe that alcohol can lower blood cholesterol levels. Indeed, cholesterol levels change under the influence of alcohol.

First, alcohol dilates blood vessels and increases blood pressure. This promotes dissolution and leaching

cholesterol plaques with blood flow. But this does not help to finally solve the problem of the negative effects of cholesterol on the body.

The level of low-density lipoproteins remains virtually unchanged when drinking alcohol. This means that the risk of developing atherosclerosis does not disappear anywhere. Under the influence of alcohol, blood vessels first expand, but then very quickly narrow. This wears out the vascular walls, they become fragile.

Regular libations have a particularly detrimental effect on the large coronary vessels, which carry oxygen to the main systems of the body - the heart and brain. Worn arteries worsen overall health and lead to poor circulation in general.
And the fact that alcohol dissolves cholesterol is not able to balance the harm that alcohol abuse causes to the body.

Age as a risk factor

Usually, when we hear the word atherosclerosis, we think of older people. And statistics confirm this fact. The fact is that all metabolic processes in the body slow down with age. The immune system works worse, the body allocates more resources and energy to support the body’s defense from external irritants, and less to self-regulation of its own systems and disposal of decay products.

Older people move less due to related problems with atherosclerosis - diseases of the joints and musculoskeletal system, spasms and sprains. Also, with age, the level of testosterone, the male sex hormone, decreases, which has a positive effect on fat metabolism and protein metabolism. It is present in both male and female bodies.

The peak of its concentration occurs in the period from 16-22 years, when the human body is being rebuilt. During this period, people are minimally susceptible to the disease, but this is not good. Usually young people do not monitor their lifestyle and nutrition, as “we only live once.”

IMPORTANT! In Western medical practice, the method of HRT (hormone replacement therapy) is used, during which patients take testosterone drugs on an ongoing basis. The results of therapy are simply stunning. Patients note not only the complete elimination of the problem, but also an improvement in overall well-being, quality of life and health in general.

You can learn about all the risk factors for the development of atherosclerosis here, and here we talked about the features of atherosclerosis in older people.

Statistics of atherosclerosis in various countries

The most prominent American scientist White considers heart disease to be a world problem. As one of the initiators of studying the statistics of atherosclerosis, as well as other cardiovascular diseases, White emphasizes the importance of a comparative study of their distribution in different countries to clarify the role of factors such as climate, living conditions, and nutrition in the origin of these diseases.

Data from many scientists indicate different statistics of atherosclerosis in different countries. These data do not always reflect the true picture, since they largely depend on a number of factors, in particular on the nomenclature of diseases adopted in the country, the essence of individual concepts, the accounting system and principles.

In the United States, atherosclerosis is widespread and is considered a more important problem than hypertension. As a cause of death among all diseases, it ranks first, surpassing even cancer. Over the past half century, the dynamics of the incidence of mass diseases, including cardiovascular diseases and, in particular, atherosclerosis, in the United States has changed dramatically. If before the First World War infectious diseases, especially tuberculosis, were of great importance, then by the beginning of the Second World War (i.e., even before the introduction of effective chemotherapeutic agents and antibiotics), the importance of infectious diseases as a cause of death dropped sharply and the role of cardiovascular diseases increased even more. -vascular diseases.

According to statistics on atherosclerosis from the American insurance company (Schepartd and Mark), in 1987, diseases of the cardiovascular system (including kidney) accounted for 33.8% of all causes of death, and in 2014 they already reached 57.1%. The structure of cardiovascular diseases also changed dramatically: rheumatic heart disease accounted for 39.5% of all cases in 1985, only 21.4% in 2014, coronary diseases (usually associated with atherosclerosis) accounted for 20.2%, while in 2014 - 44.1%.

According to statistics on atherosclerosis from the US Department of Health, in 2014, out of 5,550,000 deaths, 843,410 were due to diseases of the cardiovascular system; Among them, 425,800 cases had sclerosis of the coronary arteries, and 179,110 cases had sclerosis of the cerebral vessels. The data from Biorck is of interest. The author provides data on the structure of cardiovascular diseases in the city of Malmo for 1994–2012. During this period, coronary diseases, including myocardial infarction, began to be observed many times more often, while the number of other cardiovascular diseases increased slightly.

Clinical forms, symptoms and description

General atherosclerosis. A common form that results in blockage of blood vessels, as a result of which the outflow of blood at the site of the plaque worsens. As a result, the temperature of the area drops, the skin becomes darker, acquires a purple or blue tint, and sensitivity is lost. In advanced cases, tissue necrosis occurs.
Atherosclerosis of the heart. A situation in which plaques form directly on the walls of the heart ventricles, thereby making it difficult for them to function. It becomes harder for the heart to pump blood, the temperature of the whole body drops, and hypoxia sets in. Patients note:
noise in ears;
difficulty breathing.
Atherosclerosis of cerebral vessels (you can learn about the code for atherosclerosis of cerebral vessels here). In this case, the deposition of plaques is caused by a violation of the blood supply to the brain. The cause may be either low blood pressure or mechanical injuries. There are also cases where traumatic brain injuries received at an early age provoked atherosclerosis at a more mature age. Symptoms called by patients (you can read about the signs of cerebral atherosclerosis here):
- darkening of the eyes;
drowsiness;
weakness;
reduced body temperature.

According to the Ministry of Health of the Kirov Region, “Atherosclerosis of the cerebral arteries is manifested by a decrease in performance (especially mental), memory, attention, and fatigue. Over time, dizziness and insomnia appear. A complication of cerebral artery atherosclerosis is stroke.”

Atherosclerosis of extracranial arteries. Changes in the blood vessels of the head, as a result of which plaques accumulate. The reason for this is nicotine and tar, which reduce the elasticity of brain vessels. In response to this, under the influence of the pathogen contained in nicotine, the body increases the thickness of the vascular walls to such an extent that even the smallest plaque can create a dangerous situation. Symptoms include tremor of the limbs, cold palms, and nervous tics.
Atherosclerosis of the peripheral arteries of the extremities. Lipid metabolism disorders in the leg area. The main factor is that all the blood goes to the legs while the person is standing, and leaves from there much more slowly. People engaged in standing work are very vulnerable to this type of disease. The symptoms are as follows:
reducing their temperature;
turning blue;
loss of strength, nausea.
Atherosclerosis of the abdominal region. It affects the abdominal aorta, as it is located in close proximity to the digestive organs, and accordingly, it absorbs decay products first. Blood circulation in the lower part of the body is impaired, and lymphatic edema is possible. The most important reasons that provoke this disease are a sedentary lifestyle and obesity.

You can find out more nuances about the types of atherosclerosis here.

Diagnosis and treatment of atherosclerosis of the lower extremities

Description of the disease
Stages of atherosclerosis of the legs
Prerequisites for the development of the disease
How to recognize the disease
Diagnostic methods
Medical care options
Drug therapy
Surgical techniques
Possibilities of traditional medicine
Principles of treatment

Have you been struggling with CHOLESTEROL for many years without success?

Head of the Institute: “You will be amazed at how easy it is to lower your cholesterol just by taking it every day.

We usually attribute periodic pain in the legs to fatigue, but sometimes, especially in adulthood, such symptoms indicate a serious pathology - atherosclerosis of the legs.

Our readers successfully use Aterol to lower cholesterol. Seeing how popular this product is, we decided to bring it to your attention. Read more here...

This dangerous disease requires qualified medical care (phlebologist, cardiologist, vascular surgeon). Only then can you count on, if not a complete recovery, then at least a significant improvement in your health.

Description of the disease

Obliterating atherosclerosis of the lower extremities is a disease characterized by a whole complex of disorders: changes in the blood supply to blood vessels, developing tissue trophism. More often than others, the disease affects the large vessels of the abdominal cavity.

This provokes pathology of other arteries - popliteal, femoral, tibial - their diameter is reduced by half.

At the next stage, the lower leg and foot are affected. The disease develops over ten years and comes on unnoticed. It is diagnosed in a timely manner only in 50% of patients.

The degree of danger (death in some developed countries) is clearly demonstrated by the table, which presents WHO statistics (atherosclerosis of the legs in comparison with diabetes mellitus).

Stages of atherosclerosis of the legs

There are four stages in the formation of vascular pathology of the legs.

The first (preclinical) is characterized by lipoidosis - a serious disorder of lipid metabolism. Pain in the limbs appears only with long walking and other prolonged physical activity. The disease often develops and is asymptomatic.
At the next stage, the first symptoms of the disease appear: pain in the legs after walking 250-1000 m. The lumen of the blood vessels at this stage is 60-80% filled.
In case of critical ischemia, all signs are clearly diagnosed: pain is felt after just 50 m of walking.
The fourth stage is characterized by progressive damage to the legs by trophic ulcers, necrosis (the skin turns black and dies) and gangrene. Feelings of heaviness and pain appear in any position of the body, even at night.

In 50% of cases, atherosclerosis of the legs does not manifest itself in any way and is diagnosed only with additional examination. After 50 years, it is present in every fifth inhabitant of the planet. If treatment for atherosclerosis of the lower extremities is not started in a timely manner, surgical intervention with amputation of the leg will be required.

What else is dangerous about the disease, you can find out from this video

Prerequisites for the development of the disease

Among the main reasons that lead to atherosclerosis:

Smoking - nicotine provokes spasm of the arteries and impedes blood flow, creating all the conditions for thrombophlebitis and atherosclerosis;
Alcohol;
Obesity, the predominance of fatty and high-calorie foods in the diet, which increase the level of “bad” cholesterol.
Some diseases: diabetes mellitus, hypertension, reduction in the synthesis of sex hormones and insufficiency of the thyroid gland;
Hereditary tendency to hyperlipidemia;
Inappropriate reaction to stressful situations;
Increased blood pressure;
Age (middle and old);
Gender (the disease is more common in men);
Race (African Americans are 2.5 times more likely);
Insufficient physical activity;
Frequent mental overload;
Injuries.

How to recognize the disease

The insidiousness of the disease lies in the fact that for a long time (until the lumen of the vessels is half clogged) it does not manifest itself in anything, and when a bunch of problems appear immediately, the pathology already requires serious treatment. Only one in ten patients show signs of intermittent claudication.

Diagnostic methods

Timely differential diagnosis is the main condition for successful treatment. It helps to exclude diseases with similar symptoms such as thromboangiitis, Monckeberg sclerosis, Raynaud's syndrome, endarteritis, and sciatic neuritis.

The non-invasive method uses the capabilities of ultrasonic waves to assess the anatomical capabilities of blood vessels, the condition of the walls, internal lesions, and external compression.

If atherosclerosis of the vessels of the lower extremities is suspected, a comprehensive examination is usually offered:

MSCT angiography;
MR angiography;
Arteriography;
Doppler ultrasound of arteries;
Assessing the pulsation of the leg veins;
Monitoring blood pressure to determine the ankle-brachial index;
Consultation with a phlebologist.

Doctors check the trophism of the limbs (or lack thereof), assess the patency of blood vessels and occlusions. Using DS and ultrasound, the systolic murmurs of stenotic arteries are listened to and the degree of pulsation is assessed.

A simple test that evaluates tissue anemization also helps clarify the diagnosis: the patient, lying down, raises his legs to 45°. Knees straight. The doctor evaluates the rate of paleness of the soles and fatigue of the legs.

Photographs of problem areas help to visually monitor the dynamics of the pathological process. Peripheral angiography gives an idea of the length of the altered vascular bed, helps to assess the degree of thrombolization, the nature of the forming “bypass paths,” and the type of arteries.

Medical care options

The treatment regimen for this serious pathology depends on the stage of the disease, its duration, the degree of vascular damage and concomitant ailments. Both traditional and non-traditional therapy are used.

General recommendations

If the leg problem is not treated, the disease is fatal in 30% of patients within 5 years. Over 10 years, this figure reaches 50%. The main causes of death are myocardial infarction (60%) and stroke (12%). To achieve tangible changes for a long time, it is important to strictly follow the instructions:

Adhere to a cholesterol-controlled diet that excludes fatty meats, beef by-products, trans fats, gastronomic delicacies, confectionery, butter and high-fat cream.

Adjust body weight;
Control bad habits;
Choose comfortable shoes;
Trim your nails carefully;
Promptly treat damage to the skin of the legs;
Avoid hypothermia of the extremities;
Adjust physical activity: half an hour of quiet walking, bicycle (exercise machine), swimming;
Pay due attention to concomitant diseases.

Before drawing up a treatment regimen, the doctor studies the history of the disease to take into account all the prerequisites that provoked the development of the disease.

The set of measures is aimed at reducing the pain that occurs with intermittent claudication, restoring tolerance to stress, preventing the critical stage of vein blockage, and preventing the occurrence of ulcers and gangrene. Expert opinion – candidate of medical sciences

E.L. Malinovsky on how to treat atherosclerosis of the vessels of the lower extremities - in this video

Drug therapy

Atherosclerosis of the lower extremities is a serious disease, and it requires appropriate treatment. How are vascular pathologies of the lower extremities treated?

Antiplatelet drugs such as Aspirin or Reopoliglucin, which prevent thrombosis and its complications.
Means that activate physical endurance: Pentoxifylline and Cilostazol make walking easier and improve blood circulation in the legs.
Medicines that have antiplatelet properties – reduce the content of “bad” cholesterol and improve blood flow.
Anticoagulants such as Warfarin, Heparin, which thin the blood and prevent the formation of blood clots.
Antispasmodics – Drotaverine reduces pain and relieves spasms.
Antibiotic-based ointments in the form of Oflokain, Delaskin, Levomekol, Dimexide - if trophic ulcers are detected.
A medicine that enhances tissue nutrition - Zincteral.
Vasodilator drugs - Vazonit, Agapurin, Vazaprostan, Pentoxifylline, Pentilline, Trenal.
Statins - Lovastatin, Simvastatin, Pravastatin (for high cholesterol levels and for coronary artery disease).
Fibrates – Clofibrate, Bezafibrate (for diabetics, to reduce triglyceride concentrations).
Nicotinic acid (if there are no contraindications - liver failure, ulcers, insulin-dependent diabetes).
Vitamins and physical procedures: electrophoresis, darsonvalization, oxygenation.
For prevention, in the early stages - sequestrants of bile acids (Cholesteramine, Kolestide).

Sophora ointment is suitable for local use and is effective for leg wounds. The tincture is also prescribed to prevent hemorrhages. Recommended for rubbing: it is applied 2-3 times a day, massaging problem areas.

For tachycardia and atherosclerosis of the vessels of the lower extremities, in addition to the main treatment, additional drugs are prescribed, for example, beta-blockers.

Read also: Heart disease atherosclerosis

American doctors offer prophylaxis with aspirin and beta-blockers to all patients over the age of 45, even without symptoms of atherosclerosis. The validity of this decision is confirmed by statistics: the incidence of atherosclerosis, stroke, and heart attack in the United States is gradually decreasing.

Surgical techniques

Surgery is a last resort in treating leg disease. Surgery is prescribed only in cases of severe ischemic heart disease with severe complications, when drug therapy is powerless. The frequency of leg amputation after diagnosis within 1 year is up to 40%. What procedures are we talking about?

Bypass surgery - organizing an additional opportunity near the problem area of the artery to normalize blood flow.
Balloon angioplasty with placement of a balloon in the vascular bed to expand the clogged lumen.
Vessel stenting, when a tubular spacer is inserted into the problem artery to control the size of the lumen at the expected level.
Endarterectomy with removal of the affected area and clot accumulations.
Autodermoplasty used in the treatment of trophic ulcers that are not amenable to local therapy.
Prosthetics, which consists of replacing the affected area with an autovenous or synthetic vessel.
Amputation of the necrotic part of the leg with further prosthetics.

WHO statistics on mortality after amputation: within a year - 20%, within 5 years - up to 70%, within 10 years - up to 95%. In the UK it is the second most common cause of disability and disability.

Academician M.I. Kuzin shares his experience in treating atherosclerosis of the lower extremities in this video.

Possibilities of traditional medicine

You can clean the vessels using “grandmother’s” recipes. For atherosclerosis of the vessels of the lower extremities, the recommendations are suitable both for treatment and as preventive measures.

What is affected?

All tissues that are located next to the area of the vessel on which a plaque or thrombus forms are poorly supplied with blood, the water-electrolyte balance is disturbed, which entails edema, which compresses the walls even more, narrowing the vessel.
This increases the load on the heart , as it creates an area of uneven pressure. The central nervous system, in turn, begins to give stronger electrical impulses to contract, which can lead to a sudden heart attack at the moment when the blood clot breaks through the pump and the heart receives a super-impulse.

Progressive: why is it dangerous?

It takes a long time to pass and is unnoticeable at first; patients often go to the hospital in severe stages of the disease, when drug-free treatment will no longer help. Also, a prolonged course of the disease increases the chance of relapse, thereby prolonging treatment indefinitely.

Diagnosis for atherosclerosis includes:

Questioning a doctor about your health.
General examination of the patient for problem areas on the skin and bulging veins.
When diagnosing the lower extremities - a test to determine throughput.
Blood lipid profile analysis (read about biochemistry in atherosclerosis here).
Ultrasound of the chest organs and problem areas.
Dopplerography of blood vessels.
Diagnosis of arterial wall stiffness.

Important! All necessary procedures, their order and frequency of tests should be determined only by your attending physician.

Treatment

For the most part it is preventive in nature. The patient must adjust his lifestyle. If the situation is critical, then the patient is prescribed:

Statins.
Fibrates.
Medicines for hypertension.
Blood thinners (such as aspirin).
Peripheral validators.

If symptoms of the disease appear, you should go to the hospital at your place of residence. At the reception, you will most likely be referred to an angiologist and a neurologist, who will jointly treat the disease.

You can learn more about the treatment of atherosclerosis in this material.

Three simple tips for prevention

For prevention, it is recommended to review your diet , include vegetables rich in vitamins E and A, fiber (dill, parsley, green vegetables), and consume enough protein. The most important thing is to take in your daily intake of fats, both plant and animal. Take Omega-3 and Omega-6 supplements.
Visit the pool at least once a week, allocate 15 minutes daily for physical procedures (warm-up, stretching, yoga). It wouldn't hurt to join a sports section.
Regularly take blood tests and undergo diagnostics . A great way to do this is by donating blood. Once a year you can not only get examined for free, but also, possibly, save someone’s life.

Read more about the prevention of atherosclerosis here, and here we talked about the diet for vascular atherosclerosis.

Let's draw the line

As practice shows, we are all born sick. To survive you need to fight for your health, and sometimes for your life. It is thanks to this that natural selection and evolution take place. And despite the harsh conditions that the modern world dictates to us, we must find the strength to fight, overcome all obstacles on the path to a healthy life, putting into our genome the rules for fighting the disease.

Otherwise, at this rate, after several generations, people will die before they can pass on their genetic material to the future.

Bibliography

Dudko V. A. Atherosclerosis of the vessels of the heart and brain / V. A. Dudko, R. S. Karpov. - Tomsk: STT, 2014. - 416 p. (Code 616.13-004.6/D 81).
Zvenigorodskaya, L. A. Digestive organs and atherosclerosis [Electronic resource] / L. A.
Karpov, R. S. Atherosclerosis: pathogenesis, clinical picture, functional diagnostics, treatment / R. S. Karpov, V. A. Dudko. - Tomsk: STT, 2014. - 672 p. (Code 616.13-004.6/K 26).
Frequency and risk factors for the development of atherosclerosis in miners with dust lung pathology / N. I. Panev [et al.] // Complex problems of cardiovascular diseases. - 2014. - No. 3. - P. 71-72. — (Abstracts of the All-Russian scientific and practical conference “Epidemiology of cardiovascular diseases in the 21st century: priority areas in diagnosis and prevention. Current problems of healthcare organization”, September 18-19, 2014).
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Atherosclerosis is not a death sentence

What is atherosclerosis, how do plaques form in blood vessels?

Atherosclerosis is one of the leading causes of mortality in the world, morbidity statistics.
Features of nutrition in atherosclerosis, the role of omega-3 polyunsaturated fatty acids.
Risk factors related to atherosclerosis.
Expert opinion
Drugs that fight atherosclerosis.

Atherosclerosis is a pathological condition in which lipids are deposited in the walls of medium- and large-sized vessels, so-called “atherosclerotic plaques” are formed, which gradually leads to a narrowing of the lumen of the vessel.

Eating large amounts of animal fats leads to a significant increase in the level of cholesterol in the blood, which affects the inner walls of blood vessels and is deposited on them in the form of plaques.

The amount of blood flowing through such a vessel does not satisfy the tissue needs for it. If the vessel “serves” the lower extremities, then pain in the legs, tissue necrosis and gangrene occur.

Atherosclerotic changes in cerebral vessels lead to cerebral circulation disorders, including stroke.

When cholesterol plaques interfere with blood flow through the vessels that supply the heart muscle (myocardium), coronary heart disease develops. An attack of angina occurs, as a rule, against the background of physical or nervous stress, when the heart begins to work at an increased rate, requiring a rush of increased blood volume. However, the narrowed vessel is unable to satisfy the needs of the myocardium. There is pain in the chest area, shortness of breath. Vascular insufficiency can lead to the death of an area of the heart muscle, otherwise known as a heart attack.

Today, atherosclerosis

continues to be a leading cause of morbidity, disability and mortality. Every year in the Russian Federation, about 1 million people die from cardiovascular diseases; the standardized mortality rate in 2000 from diseases of the circulatory system was 800.9 per 100,000 population. For comparison, in France this figure is 182.8 (the lowest in Europe), in Japan - 187.4. It has been proven that the reduction in the risk of cardiovascular diseases in these countries is associated not so much with the quality of medical care, but with lifestyle and dietary habits.

In the last 20 years, special importance in nutrition has been given to eliminating the deficiency of omega-3 polyunsaturated fatty acids. It turned out that the lack of these particular PUFAs is often the cause of the development of atherosclerosis and such dangerous localizations as heart attack and stroke, arrhythmia, leading to acute heart failure with instant death. The most important of the acids in this family are eicosapentaenoic and docosahexaenoic. It has been experimentally established that the use of the most famous dietary supplement rich in omega-3 PUFAs is Eikonol. Eifitol contributed to a 6-7-fold reduction in mortality due to myocardial infarction

(the effect is attributed to the action of eicosapentaenoic acid) and an increase in the threshold of electrical stability of the heart by 2.5 times, i.e. strong antiarrhythmic (the effect is attributed to docosahexaenoic acid). To achieve a high effect of omega-3 PUFAs, the method of its preparation is very important, which does not allow the transformation of forms into trans forms.

Risk factors related to atherosclerosis:

smoking (the most dangerous factor)
hyperlipoproteinemia
arterial hypertension
diabetes
obesity
sedentary lifestyle
emotional overstrain
poor nutrition

Expert opinion

Doctor of Biological Sciences, physiologist, President of the Association of Dietary Supplements of the Russian Federation, Professor V.A. Isaev:

— Atherosclerosis is a serious disease, but it can and should be combated. Practice shows that this disease can stop its development for years and even turn towards recovery. For example, existing atherosclerotic plaques may disappear. How to achieve this? First of all, dosed physical activity and avoidance of stressful situations are necessary. It is necessary to adhere to a rational diet, in which vegetable and fish fats significantly predominate over animal fats. Physical therapy is also indicated. It’s a good idea for overweight people to lose excess weight. Do not neglect dietary supplements. In developed countries, about 90% of the population accepts them.

We have only every tenth.
Meanwhile, with the help of dietary supplements, it is possible to prevent the development of atherosclerosis
and cope with existing cholesterol plaques without harm to health or side effects.

What kind of disease is this?

How does the disease occur?

Photo

Statistics in Russia

AtherosclerosisD. A. Mantrov

Pathogenesis: what is the process?

Let's look at each stage in detail

Accumulation and modification of lipoproteins

Migration of leukocytes and formation of xanthoma cells

Proanterogenic and antiatherogenic factors

Plaque proliferation

Macroscopic changes

Microscopic pathologies

How to slow down the progression?

Risk factors and prevention of cardiovascular diseases

Risk factors for developing cardiovascular diseases

Unavoidable risk factors:

Avoidable risk factors:

PREVENTION

ADVICE OF A CARDIOLOGIST:

ALGORITHM OF ACTIONS FOR HEART PAIN.

ACUTE CEREBRAL CIRCULATION IMPAIRMENT (ACI).

Causes

Unchangeable reasons

Variable reasons

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We recommend:

Theories of origin and development mechanism

Lipid theory

Parasitic theory

Factors accelerating the development of the disease

Heredity

Smoking

Stress

Nutrition

Hormonal changes

Alcohol abuse

Age as a risk factor

Statistics of atherosclerosis in various countries

Clinical forms, symptoms and description

Diagnosis and treatment of atherosclerosis of the lower extremities

Description of the disease

Stages of atherosclerosis of the legs

Prerequisites for the development of the disease

How to recognize the disease

Diagnostic methods

Medical care options

General recommendations

Drug therapy

Surgical techniques

Possibilities of traditional medicine

What is affected?

Progressive: why is it dangerous?

Treatment

Three simple tips for prevention

Let's draw the line

Bibliography

Atherosclerosis is not a death sentence

Risk factors related to atherosclerosis:

Expert opinion