Risk factors for arteriosclerosis

Written by Zeng Wei Jie
Cardiology
Updated on September 23, 2024
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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.

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Written by Li Hai Wen
Cardiology
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How to check for arteriosclerosis?

Arteriosclerosis is a relatively common disease in our daily life. After being diagnosed with arteriosclerosis, the following tests should be considered: Firstly, blood tests, such as lipid panels, are necessary to determine the levels of blood lipids. Based on the results, medication might be required for treatment. Secondly, arterial Doppler ultrasound is useful as it can effectively detect the presence and severity of arteriosclerosis. Thirdly, arterial angiography is recommended when there is a strong suspicion of arterial narrowing due to arteriosclerosis, leading to coronary heart disease or other conditions. This test helps in determining the severity of the arteriosclerosis and in deciding the treatment plan.

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Written by Tang Li
Cardiology
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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.

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Written by Zeng Wei Jie
Cardiology
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The earliest lesions of arteriosclerosis

The earliest lesion of atherosclerosis is the formation of lipid spots and streaks. The so-called lipid spots are small yellow dots that appear on the arterial intima. Under pathological observation, these are small areas of macrophages containing lipid droplets, forming a cluster of foam cells. As this small yellow dot develops, it gradually turns into a yellow streak made up of layers of macrophages containing lipids. The intima also comprises smooth muscle cells and lipids, as well as an infiltration of T cells, resembling a yellow streak on the intima.

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Written by Zeng Wei Jie
Cardiology
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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.

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Written by Chen Ya
Geriatrics
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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.