Arteriosclerosis is divided into several stages.

Written by Zeng Wei Jie
Cardiology
Updated on September 28, 2024
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Arterial atherosclerosis sequentially manifests as three major types: lipid spots and stripes, atheromatous and fibrous atheromatous plaques, and complex lesions. According to the process of its occurrence and development, it can be subdivided into six types. The first type is lipid spots, which are small yellow spots on the arterial intima that gradually develop into the second type, lipid stripes, where some yellow stripes appear on the arterial intima. Then there is the third type, pre-lesional plaque, where more lipid droplets appear extracellularly. The fourth type is the atheromatous plaque, where lipids accumulate excessively and form lipid pools, and the intimal structure will be damaged. The fifth type is the fibrous atheromatous plaque, which is the most characteristic lesion of arterial atherosclerosis. The sixth type is a complex lesion, representing a severe condition.

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Arteriosclerosis is a disease

Arteriosclerosis is a disease characterized by thickening of the arterial wall and narrowing of the arterial lumen due to plaque formation, leading to various problems. As for whether arteriosclerosis can be prevented and treated, the answer is definitely yes. This can be achieved by maintaining good lifestyle habits. Regular exercise, quitting smoking, and controlling blood pressure and blood sugar with medications under a doctor’s guidance, as well as appropriate use of statin medications, can effectively prevent and treat the onset, progression, and worsening of arteriosclerosis.

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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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How to eliminate atherosclerotic plaques?

Arterial plaques associated with atherosclerosis are generally impossible to completely eliminate, but it is feasible to prevent the progression of the disease and strive for stable reversal. Achieving stability and reversal involves a balanced diet, appropriate physical and athletic activity, maintaining a positive mood, quitting smoking and limiting alcohol consumption, and actively controlling hypertension, diabetes, dyslipidemia, and obesity. Additionally, some medications that stabilize plaques may be necessary, mainly including lipid-modifying statins. For patients with soft plaques who are at risk of acute cardiovascular events, it may also be necessary to take anti-vascular medications. For those already showing signs of organ ischemia, interventional or surgical treatment may even be needed. (Please use medications under the guidance of a doctor.)

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Written by Cai Li E
Cardiology
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Arteriosclerosis has what manifestations?

Arteriosclerosis symptoms vary depending on the affected organ. Coronary arteriosclerosis primarily manifests as angina, while cerebral arteriosclerosis mainly results in cerebral embolism, potentially causing symptoms such as hemiplegia. Chronic cerebral ischemia can lead to cerebral atrophy and progress to vascular dementia. Aortic arteriosclerosis often displays no specific symptoms. Renal arteriosclerosis can cause refractory hypertension, and if a renal artery thrombosis occurs, it may lead to pain in the kidney area, oliguria, and fever. Chronic kidney ischemia can lead to kidney atrophy and progress to renal failure. Mesenteric arteriosclerosis can cause symptoms like indigestion, decreased intestinal tone, constipation, and abdominal pain. Arteriosclerosis in the limbs, often seen in the lower extremities, can cause symptoms such as coldness in the legs, numbness, and the typical intermittent claudication.

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Written by Zeng Wei Jie
Cardiology
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What tests are used for arteriosclerosis?

If arteriosclerosis is in the early stages, we need to understand the situation with lipids and blood sugar, so lipid and blood glucose tests should be done. Later on, when some atheromatous plaques appear, examinations such as color Doppler ultrasound and cardiac echocardiography can be done to assess blood flow and the degree of narrowing in the vessels. For some severe narrowings, consider conducting a CTA, MRI, or angiography, which can non-invasively understand the lesions of arteriosclerosis. For some patients, if there is a need for interventional treatment, invasive, selective arterial angiography can be performed to understand the condition of the lesions. Therefore, different tests can be chosen at different stages.