Today atherosclerosis is the most common cause mortality among the population of developed countries. The main factors for the occurrence of cholesterol plaques: poor condition of the walls of blood vessels, abuse of fatty foods, smoking, alcoholism, physical inactivity, genetic predisposition, chronic diseases (diabetes mellitus, hypertension, obesity), old age and male gender.

Cholesterol is a fat and performs very important functions in the body. It is included in the structure of all cells and is involved in the process of hormone production. Most cholesterol is produced in the liver, and the rest comes from food. In the human body, it is part of lipoproteins (a complex of fats and proteins), and then transferred from the liver to cells and tissues. Excess cholesterol settles in the liver and is excreted through the genitourinary system. If this process fails, the integrity and barrier function of the inner layer of blood vessels is disrupted, and atherosclerosis develops.

Initial changes occur around the age of twenty, and reach a peak at the age of forty, when the plaques become critical and life-threatening. Penetrating through the walls of blood vessels, the amount of cholesterol increases, the vessels narrow, and normal blood flow is impossible. To organs and systems human body Blood flow almost stops, inflammation and blood clots may develop.

Symptoms of vascular atherosclerosis

For a long time obvious signs There are no formations of cholesterol plaques, since the vessels compensate for their appearance by bulging outward. However, under the influence of various factors, be it physical activity, hypertension or arrhythmia, atherosclerotic plaques lose stability, and cracks and ruptures appear in the vessels. This is how blood clots develop, causing vasoconstriction. At this stage, clinical manifestations appear that the patient can already notice.

Depending on the localization of cholesterol plaques in certain arteries, the symptoms and clinical picture are different. With atherosclerosis of the coronary arteries of the heart, angina or heart attack appears. If the aorta is affected, then there is heaviness behind the sternum, pressing pain, radiating to the arms, back and neck. When the kidney vessels are damaged, the patient develops hypertension.

Rapid fatigue, decreased attention, memory and performance may indicate cerebral atherosclerosis. The progression of the disease is indicated by symptoms such as insomnia and dizziness, and a complication is indicated by a violation cerebral circulation, hemorrhages and thromboses.

Prevention

Prevention of the appearance of cholesterol plaques in blood vessels is the elimination of factors influencing their development. This means that it is necessary to exclude fatty foods from the diet, give up alcohol and smoking, normalize physical activity and avoid stressful situations.

Atherosclerosis is an insidious and sluggish disease, and its complications directly threaten health and life. Therefore, a preventive visit to the doctor, observation and testing once a year is a necessary minimum. This is especially true for people whose predisposition to atherosclerosis is a hereditary factor.

Cholesterol plaques begin to form on the walls of the arteries and grow over many years, slowly blocking blood flow. Even worse, the plaque may rupture unexpectedly, causing a blood clot (thrombus) to form over the rupture site, which can lead to a stroke or myocardial infarction.

Blocked arteries caused by the growth of cholesterol plaques and blood clots are the leading cause of death in developed countries. Lowering your cholesterol levels and eliminating other risk factors can help prevent the growth of cholesterol plaques. In some cases, it is even possible to achieve a reduction in these formations, which in turn helps to get rid of vascular and heart diseases.

Cholesterol plaques and atherosclerosis

The process of formation of cholesterol plaques, in which not only the formation of these fatty deposits occurs, but also the hardening of the arteries is called atherosclerosis. LDL or "bad cholesterol" is building material cholesterol plaques. Vascular atherosclerosis develops slowly and asymptomatically, often starting as early as childhood(usually aged 10-12 years). Eventually, the arteries can become so blocked that blood flow can be cut off altogether.

Atherosclerosis of blood vessels often causes heart attacks, strokes and peripheral artery disease. All these conditions can be classified as cardiovascular diseases. Cardiovascular disease is the No. 1 killer in developed countries, causing more than 900,000 deaths annually in America alone.

What are cholesterol plaques?

Cholesterol plaques begin to form on the walls of the arteries. Long before they can be called plaques, they appear as fatty streaks in large arteries, even in some teenagers. It is these bands that are the precursors of cholesterol plaques. They cannot be detected through diagnostic procedures, but researchers have discovered them during autopsies of young victims of accidents and violence.

Atherosclerosis develops over many years. During this period, a complex process of formation of cholesterol plaques occurs, which includes:

• Arterial endothelial damage. The smooth, delicate lining of blood vessels is called endothelium. High level cholesterol, smoking, high blood pressure (hypertension) or diabetes can damage the endothelium, creating space for cholesterol to leak into the artery wall.
• Cholesterol invasion. “Bad cholesterol” (LDL), circulating in the blood, penetrates the damaged endothelium, after which it begins to accumulate in the artery wall.
• Plaque formation. Macrophages (scavenger cells), which process various harmful substances, bacteria and cholesterol, also fill cholesterol plaques, and over many years the toxic mass of cholesterol and these cells forms a dense plaque on the artery wall.

Why are cholesterol plaques dangerous?

Once cholesterol plaques form on artery walls, they can behave in a variety of ways.

• They can grow into the artery wall. Cholesterol plaques may stop growing or may grow into the inner wall of a blood vessel without impeding blood flow.
• Plaques can slowly grow, increasingly blocking blood flow. Slow-growing cholesterol plaques may or may not cause any symptoms—even when the arteries are severely blocked.
• Cholesterol plaques may suddenly rupture - worst-case scenario. This provokes blood clotting and blood clot formation, which can lead to myocardial infarction or stroke.

The formation of cholesterol plaques (atherosclerosis) causes the development of three main types of cardiovascular diseases:

• Coronary heart disease. The presence of plaque in the arteries of the heart may not cause any symptoms or may lead to chest pain, a condition called angina. The sudden rupture of a cholesterol plaque and the formation of a blood clot in an artery can block this blood vessel, leading to the death of the heart muscle (myocardial infarction).
• Cerebrovascular disease. Cholesterol plaques can rupture in one of the brain's arteries, causing a stroke and leading to permanent brain damage. Blocked blood vessels can also cause transient ischemic attacks (TIAs). A TIA causes symptoms similar to those of a stroke, but they are temporary and do not damage the brain as much. However, patients experiencing a TIA are at very high risk of developing a stroke, and appropriate treatment should be initiated as soon as possible and all necessary precautions taken.
• Peripheral artery diseases. Blocked arteries in the legs can lead to pain when walking and poor wound healing due to poor circulation. A severe stage of the disease can lead to amputation of limbs.

Prevention

Over time, atherosclerosis progresses and cholesterol plaques increasingly narrow the ducts of important blood vessels. How to prevent the development of this insidious disease? There are nine risk factors that are responsible for up to 90% of all heart attacks. These risk factors include:

• smoking
• high cholesterol (see 12 Foods That Lower Cholesterol)
• high blood pressure
• diabetes
• abdominal obesity
• stress (see How to get rid of stress)
• insufficient consumption of fruits and vegetables
• excessive alcohol consumption
• sedentary lifestyle

You may notice that almost all of them are quite common. Experts agree that reducing and completely eliminating risk factors leads to a reduced risk of developing cardiovascular disease.

For people with moderate or end-stage atherosclerosis, daily baby aspirin may be indicated to help prevent blood clots. Before you start taking baby aspirin, check with your doctor because... this drug may cause various side effects.

How to get rid of cholesterol plaques?

If cholesterol plaques have already formed, then, as a rule, this is forever. Although when effective treatment their growth can be slowed down or even stopped.

Some evidence suggests that with persistent treatment, cholesterol plaques may even shrink slightly in size. The results of one significant study showed that after reducing blood cholesterol levels by 50%, cholesterol plaques decreased in size by 10%.

The best way to treat cholesterol plaques is to prevent their formation or progression of the disease. This can be achieved through lifestyle changes and, if necessary, appropriate treatment.

Medications and lifestyle changes to reduce the risk of atherosclerosis

Reducing and eliminating risk factors leading to the development of atherosclerosis helps to slow down or stop the development of cholesterol plaques. Ways to reduce the amount of cholesterol in the body are:

• taking medications that lower “bad cholesterol” levels
• taking medications to reduce high blood pressure
• usage folk remedies(see Treatment of atherosclerosis with folk remedies)
• healthy diet (see Diet for atherosclerosis)
• regular physical activity
• smoking cessation

These treatments won't help clear cholesterol from your arteries, but they can go some way to reducing your risk of heart attacks and strokes.

There are various medications that can help you lower your blood cholesterol levels. Among them:

• fibrates
• niacin
• bile acid sequestrants

Procedures to improve blood flow

Using invasive procedures allows doctors to see the condition of the arteries and improve blood flow or restore it by using other vessels to bypass the blocked artery. These procedures include:

• Angiography, angioplasty and stenting. Using a catheter inserted into an artery in the leg and X-rays, doctors can examine diseased arteries. This procedure is called cardiac catheterization. A tiny air balloon is inflated in the area where cholesterol plaque has severely narrowed the lumen of the vessel, after which a metal stent is implanted there, which will subsequently help keep the blocked arteries open.
• Bypass surgery. Surgeons take a healthy vessel from the leg or chest and use it to bypass the area of ​​the blocked artery, thereby restoring blood circulation.

These procedures cannot be called absolutely safe, because... they carry a certain risk of complications. A patient may be referred for one of these procedures only if he has severe symptoms associated with the presence of cholesterol plaques and cardiovascular diseases associated with atherosclerosis.