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Atherosclerosis, or "hardening of the arteries" is plaque build up in the wall of the artery. Atherosclerosis causes a narrowing (stenosis) in the channel blood takes through that artery, and can limit flow to organs that artery supplies. The atherosclerotic plaque can also fragment, or become unstable, showering pieces (emboli)  that can block small arteries distal to it. Atherosclerosis causes most strokes, heart attacks and gangrene. Atherosclerosis is a disease of arteries; it does not effect veins.

What are the risk factors?

Plaque buildup in arteries starts in most of us around the age of 30. It advances over time. The rate of plaque buildup is dependent on several risk factors, some of which we can modify, and some we cannot.

1. Age. As we get older, the risk of atherosclerosis increases.

2. Sex. Men typically develop atherosclerosis 10 years younger than women.

3. Family history. Atherosclerosis runs in families. Those who have multiple relatives with stroke, heart attack, or peripheral arterial disease in their 50's and 60's are at higher risk of developing atherosclerosis. 

4. High blood pressure. Hypertension is defined as a systolic (top number) consistently over 140 and/or  a diastolic (bottom number) consistently over 80. 

5. High cholesterol. If your LDL (bad cholesterol) is over 100, you may be considered for medication. People with documented atherosclerosis may be encouraged to shoot for a goal LDL of 70 or less, which has been proven to decrease risk of major cardiovascular events.

6. Diabetes. If you are a boderline diabetic, shedding those extra pounds, watching your diet and increasing your exercise can slow the development of atherosclerosis. 

7. Smoking. Smoking is not only linked to progression of atherosclerotic plaque, it also causes spasm of small blood vessels and increases risk of clotting. It slows down wound healing and is associated with worse outcomes after surgery.

What diseases are associated with atherosclerosis?

1. Carotid disease

2. Peripheral arterial disease (PAD)

3. Coronary artery disease (CAD), or atherosclerotic heart disease

4. Renal artery stenosis (RAS): narrowing in the arteries supplying the kidney

5. Mesenteric stenosis: narrowing in the arteries of the intestines

What can I do?

1. Know your numbers. What is your ideal body weight and how close are you to it? What does your blood pressure run? What is your LDL?
2. Watch your diet. Avoid excess sweets, salt and fats.
3. Work toward an ideal body weight
4. Keep your body active.  For anyone, any age, it is important to keep physically active.  Doing a modest amount of daily exercise is associated with better blood sugar and blood pressure control, better weight management, stress reduction and a decrease in depression, and lower risk of dementia.
5. Stop smoking
6. Talk with your doctor
7. Inform your family and friends
8. Consider screening if you have multiple risk factors.

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