Arterial Calcification: Causes, Symptoms & Treatment
Arterial calcification refers to calcium deposits in artery walls, a hallmark of atherosclerosis that significantly increases the risk of heart attack and stroke.
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Arterial calcification refers to calcium deposits in artery walls, a hallmark of atherosclerosis that significantly increases the risk of heart attack and stroke.
What Is Arterial Calcification?
Arterial calcification refers to the buildup of calcium salts within the walls of arteries. This process is a key feature of atherosclerosis (commonly known as hardening of the arteries) and mainly affects middle-aged and older adults. As calcium accumulates, artery walls become stiffer, blood vessels narrow, and normal blood flow is impaired.
Causes
Arterial calcification develops through a complex process involving the deposition of fats, cholesterol, calcium, and other substances in artery walls. The main risk factors include:
- Elevated blood lipid levels (hypercholesterolemia)
- High blood pressure (hypertension)
- Diabetes mellitus
- Smoking
- Physical inactivity and an unhealthy diet
- Chronic kidney disease, which disrupts calcium and phosphate metabolism
- Genetic predisposition and advancing age
Symptoms
Arterial calcification often causes no symptoms in its early stages. As it progresses, the following may occur:
- Chest pain or tightness (angina pectoris) when the coronary arteries are affected
- Shortness of breath and reduced exercise tolerance
- Leg pain when walking (peripheral artery disease)
- Dizziness or temporary neurological deficits when cerebral arteries are involved
- Erectile dysfunction as an early warning sign
In severe cases, arterial calcification can lead to a heart attack or stroke.
Diagnosis
Arterial calcification is diagnosed using various medical examinations:
- Blood tests: Assessment of cholesterol levels, blood sugar, and kidney function
- Ultrasound (sonography): Visualization of vessel walls, e.g., carotid duplex ultrasound
- CT coronary angiography: Measurement of the calcium score (Agatston score) to evaluate coronary artery calcification
- Ankle-brachial index (ABI): Blood pressure comparison between the ankle and arm to assess peripheral artery disease
- ECG and stress ECG: Evaluation of heart function
Treatment
Arterial calcification cannot be fully reversed, but its progression can be significantly slowed. Treatment includes:
Lifestyle Changes
- Heart-healthy diet (e.g., Mediterranean diet)
- Regular physical activity
- Smoking cessation
- Weight loss in overweight individuals
Medical Therapy
- Statins: Lower LDL cholesterol and have anti-inflammatory effects
- Antihypertensive medications: Reduce blood pressure
- Antiplatelet agents (e.g., aspirin): Prevent blood clots
- Antidiabetic drugs: Blood sugar control in diabetes
Interventional and Surgical Procedures
- Balloon angioplasty (PTCA) with or without stent placement for narrowed coronary arteries
- Bypass surgery for severe obstructions
- Carotid endarterectomy for severe carotid artery calcification
References
- Libby P. et al. - Atherosclerosis. In: Harrison's Principles of Internal Medicine, 21st Edition, McGraw-Hill, 2022.
- Visseren F.L.J. et al. - 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. European Heart Journal, 2021. DOI: 10.1093/eurheartj/ehab484.
- Roth G.A. et al. - Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019. Journal of the American College of Cardiology, 2020. DOI: 10.1016/j.jacc.2020.11.010.
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