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Atherosclerosis Risk: Causes, Symptoms and Prevention

Atherosclerosis risk refers to the likelihood of developing a hardening and narrowing of the arteries. Key risk factors include high blood pressure, smoking, and elevated cholesterol levels.

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Things worth knowing about "Atherosclerosis Risk"

Atherosclerosis risk refers to the likelihood of developing a hardening and narrowing of the arteries. Key risk factors include high blood pressure, smoking, and elevated cholesterol levels.

What is Atherosclerosis Risk?

Atherosclerosis risk describes an individual person´s likelihood of developing atherosclerosis, a condition in which fatty deposits, cholesterol, calcium, and other substances build up inside the walls of the arteries. These deposits, known as plaques, narrow the arteries, reduce blood flow, and can lead to life-threatening events such as heart attack or stroke.

Risk Factors

Atherosclerosis risk is influenced by a variety of factors, which are broadly divided into non-modifiable and modifiable risk factors.

Non-Modifiable Risk Factors

Age: Risk increases significantly with advancing age.
Sex: Men tend to develop atherosclerosis earlier than women.
Family history: A genetic predisposition substantially raises the risk.

Modifiable Risk Factors

High blood pressure (hypertension): Persistently elevated blood pressure damages arterial walls.
Elevated cholesterol (hypercholesterolaemia): High LDL cholesterol levels in particular promote plaque formation.
Smoking: Damages blood vessel walls and promotes inflammatory processes.
Diabetes mellitus: Chronically elevated blood sugar levels damage blood vessels over time.
Overweight and obesity: Contribute to other risk factors such as hypertension and diabetes.
Physical inactivity: A sedentary lifestyle increases cardiovascular risk.
Unhealthy diet: Diets high in saturated fats and sugar accelerate plaque buildup.
Chronic stress: Can raise blood pressure and inflammatory markers.

Symptoms and Complications

Atherosclerosis usually develops silently over decades without noticeable symptoms. Symptoms typically appear only when arteries become significantly narrowed or blocked. Possible complications include:

Coronary artery disease (CAD) with chest pain (angina pectoris) or heart attack
Stroke due to impaired blood flow to the brain
Peripheral artery disease (PAD) causing leg pain during walking
Renal artery stenosis leading to high blood pressure and reduced kidney function

Diagnosis

Several diagnostic methods are available to assess an individual´s atherosclerosis risk:

Blood tests: Measurement of cholesterol, blood glucose, inflammatory markers (e.g., CRP), and other values
Blood pressure measurement: Detection of hypertension
ECG and stress ECG: Assessment of cardiac function
Ultrasound (Doppler sonography): Visualisation of vascular changes, e.g., in the carotid arteries
Ankle-brachial index (ABI): A simple test to detect peripheral artery disease
Risk scores: Calculators such as SCORE2 (ESC) estimate the 10-year risk of cardiovascular events.

Prevention and Treatment

The encouraging news is that atherosclerosis risk can be significantly reduced through a healthy lifestyle and medical interventions.

Lifestyle Changes

Quitting smoking
Heart-healthy diet (e.g., Mediterranean-style diet)
Regular physical activity (at least 150 minutes of moderate exercise per week)
Weight management
Stress reduction

Medical Treatment

Statins: Lower LDL cholesterol levels and help stabilise plaques
Antihypertensives: Medications to reduce blood pressure
Antidiabetic agents: Blood sugar management in diabetes
Antiplatelet agents: Prevent blood clotting on plaques (e.g., acetylsalicylic acid)

References

Libby, P. et al. – Atherosclerosis. Nature Reviews Disease Primers, 2019. Available at: https://www.nature.com/articles/s41572-019-0106-z
European Society of Cardiology (ESC) – Guidelines on Cardiovascular Disease Prevention. European Heart Journal, 2021.
World Health Organization (WHO) – Cardiovascular diseases (CVDs) Fact Sheet. Geneva, 2023. Available at: https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)

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