Atherosclerosis
As atherosclerosis is by far the most common cause of arterial disease, it is
worth while to discuss this disease process in more detail.
While a patient may present with a complaint of leg pain while walking due to
blockage of his or her leg arteries, the most relevant factor may not be the leg
pain, but an increased risk of heart attack or stroke. This is because
atherosclerosis in one area (such as a leg artery) may imply atherosclerosis in
another area (such as in an artery supplying the heart or brain).
Accordingly, when seeing patients with an arterial blockage due to
atherosclerosis in one area of the body, it is frequently necessary to spend time
discussing atherosclerosis in general, not only as to how it relates to the
presenting problem.
Atherosclerosis has several known risk factors, which means items in an
individual’s medical history that are more common in those with atherosclerosis
than in those without atherosclerosis. A patient with atherosclerosis typically will
not have all of these risk factors, and rarely, some will have none, but most
patients with atherosclerosis will have at least some.
The common risk factors are:
- Family History (peripheral arterial disease, heart attack, stroke, etc.)
- Hypertension (elevated blood pressure)
- Hyperlipidemia (elevated cholesterol or other fatty elements in the blood)
- Diabetes (sometimes undiagnosed)
- Tobacco use (past or current)
- Obesity
- Sedentary lifestyle
- Age (like many things, atherosclerosis becomes more significant as we age)
Therefore, in addition to managing the presenting problem, one must also
ensure that patients are educated regarding atherosclerosis and its risk factors,
and that any correctable risk factors are appropriately addressed.
Many patients with atherosclerosis will benefit from certain interventions, such as
a better diet, more exercise, weight loss, and cessation of tobacco use. In
addition, many patients will also benefit from the addition of specific
medications, such as Aspirin or similar agents designed to affect platelets
(elements in blood responsible for clotting) and Statin therapy for control of
hyperlipidemia. It is worthwhile to remember that while a given patient’s blood
pressure, glucose and/or cholesterol levels may be “normal” (compared to the
general population, with and without a diagnosis of atherosclerosis), it may be
too high for them, given the fact that they have atherosclerosis.
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