What is atherosclerosis?
Under atherosclerosis, often colloquially referred to as hardening of the arteries, refers to a systemic disease of the arteries (arteries), the. To deposits of blood lipids, blood clots, connective tissue and in smaller amounts and lime (and not to) take the vessel walls.
Atherosclerosis definition
The sequelae of atherosclerosis are the leading cause of death in Western industrialized nations. This form of sclerosis is a particular focus of medical, biochemical and biomechanical research. Atherosclerosis is a disease of the arterial system, slow, often develops over decades without symptoms until it can be manifested by ischemia, thrombosis, angina pectoris, myocardial infarction, stroke, or sudden cardiac death.
Hallmark of the disease is a chronic, progressive degeneration of the arterial walls. By connective tissue proliferation, intracellular and extracellular deposits of cholesterol, fatty acids and lime and accumulation of collagen and proteoglycans leads to a hardening and thickening of the vessel walls associated with a decreased elasticity of the vessel walls and usually also lead to narrowing of the vessel lumen.
Literally translated, means atherosclerosis connective tissue hardening of the arteries. The separation of the two terms arteriosclerosis and atherosclerosis has a historical origin: is formed primarily during atherosclerosis by damage to the inner vessel wall and as (Food) Prosperity disease earlier was far less than it is today, atherosclerosis occurs mainly within the central vessel wall. (More precisely, arteriosclerosis type Mönckeberg, it arises as Mediakalzinose).
The term atherosclerosis stresses accordingly the histological changes which are of arteriosclerosis based on, ie, the herd chronically developing shaped changes in the mesenchymal cells of the inner vessel wall (intima) of the inner and middle layers of the vessel wall (Media). They are often also referred to as plaques.
Atherosclerosis ("hardening of the arteries") indicates the physiological aging process of an artery, while the term atherosclerosis emphasizes the formation of a pathological atheroma, causing stenosis under certain circumstances.
Atherosclerosis risk factors
The PROCAM study identifies risk factors (in order of relevance):
-Gender (Androtropie)
-Age
-LDL-cholesterol (hypercholesterolemia, hyperlipidemia)
-Smoking status (tobacco smoking)
-HDL cholesterol
-Systolic blood pressure (hypertension)
-Premature heart attacks in the family (family history)
-Diabetes (diabetes mellitus)
-Triglycerides
There is evidence to suggest that the quality of the food and the compilation play a role, they appear to have a Mediterranean a low-fat diet to consider.
Atherosclerosis treatment and preventive measures
The prevention and treatment of atherosclerosis are largely identical and differ mainly in their respective proportions. In the treatment options only the invasive medical (surgical) interventions are added. For the mere prevention of primary importance if otherwise healthy people are generally sufficient exercise and a healthy diet.
Medical therapy
drug / non-invasive
-High pressure reductions: ACE inhibitors, diuretics, AT1-receptor blockers, beta blockers, calcium antagonists
-Lowering cholesterol: statins, ezetimibe, polyphenols
-Lowering triglycerides: Omega-3 fatty acid ethyl ester, fibrates, nicotinic acid
-Anticoagulation: aspirin, clopidogrel, dipyridamole
-Drug therapy risk-enhancing additional illnesses (risk factors)
Invasive
-Bypass surgery on the heart or legs
-Thromboendarterectomy of the leg or carotid artery
-Aufdehnungen by balloon dilation or stent
Invasive therapy risk-increasing additional illnesses (risk factors)
Prevention of Risk Factors
-Chronic high blood pressure should be normalized.
-Tobacco smoking should be completely set: Since nicotine has vasoconstrictive effect from low doses, a mere reduction of the supply is not pointless, but of much smaller effect than the total abandonment.
-Specific conditions that increase the risk of atherosclerosis must be treated and their risk factors are avoided. These include diabetes mellitus and chronic renal failure (see also: risk factors).
-Strong, persistent, negative stress should be avoided. He favored among other things, the risk factors for high blood pressure and obesity.
-The body weight should be up to slightly overweight in the normal range. People with extreme obesity have more frequent and / or more arteriosclerotic changes.
-It is recommended to lower high cholesterol with medication. The link between high cholesterol levels and the development of coronary heart disease is controversial (see also: Main article cholesterol paragraph: doubt on the causal chain Nutrition - Cholesterol - CHD disease).
Motion
Sufficient movement already in lighter form (walks) can have a significant impact on education and history of atherosclerotic disease. As a regular sports endurance sports in the extent of recreational sports are recommended. Sport in the amount of competitive sports is recommended not considered necessary yet.
-Walks, from day 20 minutes (if no other sport is added).
-Jogging, cycling, swimming, skating, ball and team sports, etc.
-Sports Studio: In Studio endurance training should be emphasized in courses and related equipment.
Nutrition
The general rules of healthy human diet should be followed (including plenty of vegetables, fruits and whole grains). Especially recommended but is associated with atherosclerosis in the traditional Mediterranean diet.
-Dietary fiber (especially soluble) from whole grains, legumes, vegetables reduce LDL cholesterol levels. Fiber bind bile acid, which then is not to emulsify the fats available. In order to satisfy the requirement bile acid, the liver increases the synthesis. For the synthesis of bile, the liver LDL cholesterol must deduct from the bloodstream. Furthermore, fiber is important for a healthy bowel movement with their generally positive consequences for the organism.
-Saturated fatty acids increase (in fixed vegetable fats and especially in animal fats) the daily caloric intake without the health benefits of unsaturated fatty acids. Therefore, one should partially waive these fats and replace them with one and polyunsaturated fats.The monounsaturated oleic acid, abundant in olive oil and canola oil, lowers LDL cholesterol without the beneficial HDL cholesterol to change. Polyunsaturated fatty acids such as linoleic acid (omega-6 fatty acid) and alpha-linolenic acid (omega-3 fatty acids) reduce total cholesterol levels. The ratio of omega-6: omega-3 should not exceed 5: 1, since both fatty acids compete for the same enzyme systems. By far the most favorable ratio has linseed oil with about 1: 4; Linseed oil has both the highest proportion of omega-3 fatty acids of all edible oils. Nuts and fatty fish (herring, salmon,Greenland halibut) also have favorable fatty acid pattern. Linoleic and linolenic acids also have anti-inflammatory (though partly. Also promote inflammation, especially linoleic acid).
-Arginine is an essential for the maintenance of vascular health food amino acid that can be successfully used in dietary treatment for atherosclerosis. The metabolic abnormalities underlying this disease is based can be favorably influenced by increased nitric oxide formation (NO) from arginine, and thus a causal treatment is possible with a nutrient. All through the endogenous antagonist of arginine, asymmetric dimethylarginine the (ADMA), triggered pro-oxidative and inflammatory degenerative processes can be successfully compensated. Arginine is often combined with B vitamins, in order to reduce the concentration of homocysteine that inhibits the degradation of ADMA.
-Reduce antioxidants such as vitamin E (nuts, vegetable oils), vitamin C and carotenoids from vegetables and fruit and other phytonutrients oxidative stress. The artificial supply in the form of dietary supplements should be limited or done in cases of proven violation, since they do not replace a balanced diet and healthy lifestyle. Isolated phytochemicals have proven far from the action as the whole food.
-In salt-sensitive hypertensive patients, the replacement of saline in favor of herbs and spices to add flavor makes sense.
-Fried, grilled, fried and baked foods and foods for particular method artificially hardened fats contain (eg for older method produced margarine) should be eaten rarely due to the high proportion of harmful trans fatty acids.