Atherosclerosis


Risk factors for arteriosclerosis
The etiology of atherosclerosis is not yet fully understood, but the main risk factors include age and gender. The older the age, the higher the probability of occurrence, and the probability in men is higher than in women. Abnormal blood lipids, with the main treatment target being low-density lipoprotein, hypertension, smoking, glucose tolerance abnormalities, and obesity are all possible risk factors. Additionally, we cannot ignore family history; if there is a history of early-onset coronary heart disease in the family, then this risk factor is also very high. Moreover, personality is related, with Type A personalities being more prone to atherosclerosis. Dietary habits are also related; patients who often eat high-calorie, high-animal-fat, high-cholesterol foods are prone to develop the condition. There are also patients taking oral contraceptives, who are likely to develop atherosclerosis.


Can arteriosclerosis be treated with moxibustion?
Arteriosclerosis can be treated with moxibustion. Moxibustion is a traditional disease treatment method in Chinese medicine, which can treat many diseases clinically. For patients with arteriosclerosis, moxibustion therapy can improve some clinical symptoms caused by arteriosclerosis. However, one should not rely solely on moxibustion for the treatment of atherosclerosis, as the mechanism of atherosclerosis is due to the disorder of lipid metabolism and the hardening of arterial walls caused by increased blood lipids. Treatment should include medication and dietary adjustments such as low-salt, low-sugar, and low-fat diets, and avoiding fatty meats, animal offal, and seafood high in cholesterol.


The difference between arteriosclerosis and atherosclerosis.
Arteriosclerosis and atherosclerosis are two different concepts. Arteriosclerosis is a type of vascular disease within arteriosclerosis, but atherosclerosis is more commonly significant clinically. Hence, it is customarily referred to simply as arteriosclerosis, generally implying atherosclerosis. The causes of arteriosclerosis are numerous, but they share common characteristics including thickening, hardening, loss of elasticity, and narrowing of the arterial walls. Atherosclerosis is characterized by lesions starting in the innermost layer of the artery, involving local accumulation of lipids, complex carbohydrates, fibrous tissue proliferation, and calcification forming plaques, along with a gradual degeneration of the innermost layer. The lipid accumulation gives the inner layer a yellowish, porridge-like appearance, hence the name atherosclerosis.


How is arteriosclerosis treated?
The treatment of arteriosclerosis includes general preventive measures, pharmacological treatment interventions, and surgical interventions. General protective measures include reasonable dietary practices, appropriate physical exercise, proper arrangement of work and life, maintaining a pleasant mood, quitting smoking, limiting alcohol consumption, and controlling some disease-related risk factors such as hypertension, diabetes, dyslipidemia, obesity, etc. The main pharmacological treatment focuses on lipid-lowering and antiplatelet medication. For some patients with symptoms of angina pectoris, such as symptoms of target organ damage, treatment may involve dilating the blood vessels. Interventional treatment indications are now relatively broad. For some who are not suitable for interventional procedures, surgical treatments can be considered.


Causes of Arteriosclerosis
Arteriosclerosis, the most common and important type of arteriosclerosis, is characterized by thickening and hardening of the arterial walls, loss of elasticity, and narrowing of the lumen. The causes are currently considered to be related to several factors, including age and gender, with older males being more prone. Patients with abnormal blood lipids, hypertension, smokers, those with diabetes or impaired glucose tolerance, obese patients, and those with a family history are all more likely to develop arteriosclerosis. Due to the incomplete certainty of the causes, its prevention and control are also managed through multiple factors.


How long can one live with arteriosclerosis?
Arteriosclerosis has a certain impact on survival and longevity, but it is not an absolute determinant. People with mild arteriosclerosis have fewer sudden incidents of cerebral infarction and myocardial infarction, thus they may have a longer survival period. However, if arteriosclerosis leads to myocardial infarction or cerebral infarction, it will also affect their lifespan, but there is no absolute conclusion.


Causes of arteriosclerosis
The etiology of arteriosclerosis has not been fully determined, and studies indicate that arteriosclerosis is a multifactorial disease, caused by multiple factors acting at different stages, which are referred to as risk factors. The primary risk factors include the following: First, age and gender. Clinically, it is more common in middle-aged and elderly people over forty years old. After the age of forty-nine, the progression is fast, but early arteriosclerotic changes have also been found in autopsy of some young adults and even children. In recent years, clinical onset age tends to be younger. Compared to men, the incidence rate in women is lower, because estrogen has a protective effect against arteriosclerosis. Therefore, the incidence rate in women increases rapidly after menopause. Age and gender are unchangeable risk factors. Second, abnormal lipid levels, with abnormal lipid metabolism being the most important risk factor for arteriosclerosis. Third, hypertension, as the incidence of arteriosclerosis in patients with hypertension is significantly higher. Sixty to seventy percent of patients with coronary arteriosclerosis have hypertension, and patients with hypertension are three to four times more likely to have arteriosclerosis compared to those with normal blood pressure. Fourth, smoking, as the incidence and mortality rate of coronary arteriosclerosis in smokers are two to six times higher than in non-smokers, and it correlates positively with the number of cigarettes smoked daily. Secondhand smoke is also a risk factor. Fifth, diabetes and glucose intolerance, where not only is the incidence of arteriosclerosis in diabetic patients several times higher than in non-diabetics, but the progression of the disease is also rapid. Sixth, obesity, defined as being more than twenty percent over the standard weight or a BMI greater than twenty-four. Obesity is also a risk factor for arteriosclerosis. Seventh, family history, where a family history of coronary heart disease, diabetes, hypertension, and hyperlipidemia significantly increases the incidence of coronary heart disease. Various theories have been proposed to explain the pathogenesis of coronary arteriosclerosis from different perspectives. These include the lipid infiltration theory, thrombosis theory, and smooth muscle cell clonal theory. In recent years, the endothelial damage response theory has gained more support, suggesting that the disease results from various risk factors ultimately damaging the arterial intima, and the formation of arteriosclerosis lesions is an inflammatory, fibro-proliferative response of the arteries to endothelial damage.


How is arteriosclerosis treated?
To treat arteriosclerosis, we differentiate treatments based on the severity of the condition. For early-stage patients, we emphasize the control of lipids, blood pressure, and blood sugar to potentially slow the progression of arteriosclerosis. For patients who have already suffered damage to target organs, such as cerebral infarction, myocardial infarction, renal artery stenosis, or mesenteric artery stenosis, treatment might significantly rely on medication, and could possibly require the use of stents or even surgical bypass procedures. For the general population, we emphasize primary prevention, which includes a reasonable diet, appropriate exercise, and a balanced mental state to effectively prevent the disease.


Can arteriosclerosis be cured?
Atherosclerosis can only slow down its further progression and prevent the further occurrence of conditions such as coronary heart disease, cerebral infarction, and lower limb arterial occlusion. This is because it is influenced by many factors, including both modifiable and non-modifiable risk factors. For example, modifiable factors include abnormal blood lipids, hypertension, diabetes, smoking, and overweight obesity, which we can change. However, there are also non-modifiable factors such as age, genetics, and environmental factors. As age increases, the incidence of atherosclerosis significantly rises. Its pathological changes generally begin in childhood or adolescence, with symptoms becoming more apparent as age progresses.


Treatment of Arteriosclerosis
The treatment of arteriosclerosis includes general preventative measures, pharmacological treatment, interventional procedures, and surgical operations. General precautions involve a balanced diet, with some patients needing to lose weight, increasing the intake of fruits and vegetables, quitting smoking and limiting alcohol consumption, and adopting a low-fat diet. Additionally, it is advised that patients engage in appropriate physical labor and sports activities, while also maintaining an optimistic and calm mindset. Pharmacological treatment is quite specialized, mainly including lipid-lowering and antiplatelet therapies. Then, there are cases with clear symptoms, such as renal artery stenosis or coronary artery narrowing, where interventional treatments can be considered. For those unsuitable for interventional procedures, surgical treatments, such as bypass surgery, might be considered.