✔ Atherosclerotic Cardiovascular Diseases
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Atherosclerotic cardiovascular disease: causes, pathogenesis, and prevention
Atherosclerosis is a chronic disease of the blood vessels, the disease is considered to be one of the main causes of cardiovascular in the world. It is characterized by the deposition of lipids, in particular, LDL‑cholesterol, inflammatory cells, and fibrous tissue in the intimal layer of the arteries. These deposits, as Plaques, referred to, lead to a narrowing of the vessel lumen (stenosis) and a restriction of the blood supply to the organs.
Causes and risk factors
The development of atherosclerosis is influenced by a combination of genetic and environmental factors. Of the modifiable risk factors include:
Hyperlipidemia (elevated concentration of LDL‑cholesterol and triglycerides);
Arterial Hypertension;
Tobacco consumption;
Diabetes mellitus type 2;
Overweight and obesity;
Lack of exercise;
unhealthy diet (high consumption of saturated fatty acids and TRANS-fats).
Non-modifiable risk factors include age, gender (men are affected up to the menopause age) and a family history of early cardiovascular disease.
Pathogenesis
The pathological process begins with damage to the endothelial cell Association, often caused by mechanical stress factors or toxic substances (e.g., nicotine). This damage leads to increased permeability of the vascular wall, and the adhesion of monocytes and T‑lymphocytes. The monocytes to differentiate to macrophages, oxidized LDL‑cholesterol, become foam cells. This marked the beginning of the Plaque formation.
In the further course of a fibrous cap over the lipid core region, is formed. Unstable Plaques with a thin cap and a large lipid core are particularly dangerous, as they can tear. The subsequent thrombus formation process can lead to acute cardiovascular events, such as:
Myocardial infarction;
Stroke (particularly ischemic type);
peripheral arterial occlusive disease.
Clinical Manifestations
Depending on the affected artery, the clinical symptoms vary:
Coronary atherosclerosis: Angina pectoris, myocardial infarction.
Cerebral atherosclerosis: Transient ischemic attacks (TIA), ischemic stroke.
Peripheral atherosclerosis: intermittent claudication (pain when walking), gangrene.
Diagnostics
For the diagnosis, various methods are used:
Laboratory tests (lipid spectrum, C‑reactive Protein);
non‑invasive imaging techniques (ultrasound of the carotid arteries, Coronary CT angiography);
invasive procedures (cardiac catheterization with angiography).
Prevention and therapy
Effective prevention includes both lifestyle-related measures as well as drug therapies:
Style changes: Smoking abstinence, well‑balanced diet with a focus on dietary fiber, Omega‑3 fatty acids and unsaturated fatty acids, regular physical activity, weight reduction life.
Drug Therapy:
Statins for the reduction of LDL‑cholesterol;
Antihypertensives to control blood pressure;
Hypoglycemic agents in the Presence of Diabetes;
Anti aggreganzien (for example, acetylsalicylic acid) prophylaxis for Thrombus.
In severe cases: interventional or surgical procedures (balloon dilatation, stent implantation, Bypass surgery).
Conclusion
Atherosclerotic cardiovascular disease is a serious health challenge. Early identification of risk factors, a more aggressive prevention and targeted therapy can slow the progression of the disease and the Occurrence of life-threatening complications is significantly reduced.
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