GSE
Most cardiovascular disease (CVD) and peripheral artery disease (PAD) is a consequence of atherosclerosis - Build-up of arterial plaque
Atherosclerosis is a life-saving INFLAMMATORY RESPONSE to
prevent you from bleeding to death!
What is atherosclerosis? (Greek: athero=paste,
sclerosis=hardening)
Atherosclerosis occurs as a result of the immune
system's INFLAMMATORY RESPONSE to an arterial blood vessel wall DAMAGE.
Intended as a temporary fix, plaque (a
paste mainly consisting of cholesterol and fat) is laid down to prevent bleeding
out through a damaged arterial wall.
Based on his detailed autopsy studies and pathology investigations
of those who had died of heart disease, late 19th century, German physiologist
Rudolph Virchow proposed that the origin of heart disease was inflammation
of the heart and the arteries. He found that their arteries looked as
though they had been wounded inside, similar to an infected skin abrasion
Why be concerned about atherosclerosis?
Most cardiovascular disease (CVD) and peripheral
artery disease (PAD) is a consequence of atherosclerosis . If the actual cause of arterial wall damage is
not addressed, arterial plaques can grow in size, causing a narrowing (stenosis)
of the arterial lumen. Not only does this increase blood pressure, but eventually
it can block the smaller
arteries - such as the coronary arteries providing blood to
the heart (causing a heart attack), or a piece can break away from plaque,
travel in the bloodstream and end up blocking / bursting the small arteries in
the brain (causing strokes), or blocking peripheral arteries to the legs, feet or
arms (causing pain and / or nerve / tissue damage), or setting the stage for several
other undesirable possibilities:
Coronary Heart Disease
(CHD) - atherosclerosis narrows the coronary arteriesHeart
attack (myocardial infarction) - a blood clot develops from plaque, typically
in one of the coronary arteries, causing a blockage, called a thrombosis), which
blocks the oxygen supply to the heartArrhythmia
- irregular heartbeatStroke
- blockage
of carotid artery supplying oxygenated blood to the brainAngina
- chest
painHypertension
(high blood pressure) Thrombosis
- clot formation attached to blood vessel wall in an artery or vein obstructing
blood flow; Hemorrhagic burst
(blood vessel rupture). Peripheral artery disease (PAD)
Atherosclerosis is sometimes accompanied by hardening of the lumen
(arteriosclerosis), which eventually:
Decreases circulation
And reduces arterial elasticity
Compromises the dilation of
blood vessels when needed - such as during strenuous exercise.
Where does injury / atherosclerosis occur?
Plaque accumulation (swelling) is always in the intima
(between the endothelial lining and the smooth muscle wall)
Atherosclerotic plaques characteristically occur in high
pressure / turbulent areas in arterial blood vessels
In regions of branching and marked curvature at
areas of geometric irregularity. i.e. where blood
undergoes sudden changes in velocity and direction of flow.
It does
not occur in veins carrying deoxygenated blood.
i.e. under pressure 8 times lower than the arteries
Occurs In any
medium / large artery supplying oxygenated blood under high pressure, but most frequently affects the following arteries:
Aorta - Largest artery - supplies blood to all body parts . The aorta
extends about 1 foot from the heart to the pelvis, however, plaque most commonly
occurs in the abdominal aorta and if present there, it is probably in other
arteries)Coronary arteries leading to coronary heart / artery disease (i.e. CHD or CAD).
There are 2 main coronary arteries that branch off the aorta and supply
blood to the heart muscle. Atherosclerosis/arteriosclerosis reduces their supply, leading to
blood insufficiency (ischemia) to the heart;
(There's that incorrect depiction of plaque placement
again! :))
Peripheral arteries
Iliac / Femoral Arteries
- atherosclerosis / arteriosclerosis causes a decrease in blood
flow to the legs and feet that can injure nerves and other tissues.Axillary / Brachial Arteries.
Arm artery disease is a rare form of PAD, but the most common cause is atherosclerosis
in the arm arteries, which can cut off circulation to the hand; symptoms include
pain, weakness, fingers turning blue, and gangrene.
Carotid and Vertebral Arteries. Atherosclerosis
reduces the oxygen-rich blood supply to the brain. Carotid artery disease accounts
for well over 95% of symptoms causing cerebrovascular disease. When the carotid
arteries are obstructed, you are at an increased risk for a stroke.
Why does atherosclerosis occur?
COntrary
1. Weakened arterial walls
Ascorbate deficiency
is the primary cause of a weakened wall
Weak, ascorbate -deficient,
vessel walls are more easily damaged by injurious mechanisms
Vitamin C (together
with the amino acids lysine and proline), maintain arterial
structural integrity by their role in forming connective tissue components collagen
and elastin. Arteries (and every other body tissue) constantly
undergo decay, repair, and replacement. Tissue repair and replacement requires a
binding protein called collagen, which the body produces using
vitamin C (ascorbate).
An insufficiency of ascorbate will cause artery
walls to form lesions (wounds) as they fall into disrepair.
A chronic deficiency of
vitamin C leads to chronic scurvy.
Eventually the lesions would rupture and you would bleed to death through
the arterial wall.
Weak Walls
(Due to chronic scurvy)
CVD (related to atherosclerosis) - A Simple Cure
2. Injuries to arterial wall
Progression rate of atherosclerosis in CVD
Atherosclerosis can sometimes progress unnoticed
for decades - until its first symptoms and signs appear in the advanced
stage, often announcing itself as a "sudden" heart attack.Ultrasound studies demonstrate
coronary atherosclerosis exists in 37% of "healthy"heart donors aged
20-29, 60% of those 30-39, and in 85% of those older than 50.
CVD can develop from a young age. 77% of 300 American soldiers killed in Korea, average age 22 years,
had gross evidence of arteriosclerosis Enos WF et al, Coronary disease among United States soldiers killed
I action in Korea. J Amer Med Assoc, 1953. Similar findings were reported in American college students, who
died in auto accidents
Atherosclerosis can also develop erratically and
rapidly. Records
involving the photographing of arteries (called arteriography or angiography) as
plaque develops in patients showing CVD symptoms, clearly demonstrate that development
can also be erratic and develop rapidly in just a few months. A university hospital
study in Germany compared slow and rapid atherosclerosis progression in 79 patients
with CHD using angiography.
Results indicated
that rapid progression was NOT determined by: Age differences,
sex, number of vessels diseased, interval between angiographies, smoking, having
hypertension or diabetes mellitus, or on serum concentrations of LDL cholesterol,
HDL cholesterol, triglycerides, and/or Apo B. However, it was found that elevated Lipoprotein(a) levels
are a clear risk factor for the rapid angiographic progression of coronary heart
disease (CHD). The link between Lp(a) and rapid progression may
be the effect Lp(a) has in preventing blood clot dissolution. As typically observed,
average Lp(a) concentrations in all patients were higher than in healthy subjects.
(Note: The angiographic picture of progressive narrowing may have included the accelerated
proliferation of vascular wall cells). Wolfram Terres, MD et al, Rapid Angiographic Progression
of Coronary Artery Disease in Patients With Elevated Lipoprotein(a),Circulation
(AHA),1995
Lp(a) -"The Repair Man"
