Atherosclerosis Hardening of the Arteries

The adult human body contains a complex circulatory system composed of about 100,000 miles of blood vessels, of which there are three types: arteries, veins, and capillaries. Arteries carry oxygen- and nutrient-rich blood away from the heart and to cells; capillaries connect arteries to veins and facilitate the exchange of oxygen and carbon dioxide, and veins carry oxygen-depleted blood back to the heart. A robust blood supply is therefore vital to good health. Of all the organs, the brain and the heart are most vulnerable to impaired circulatory function. Under most circumstances, the brain can survive only thirty minutes of interrupted blood supply. Heart muscle is slightly more resistant, mainly because it can use a wider variety of energy fuels to support its metabolism than the brain can, which depends solely on glucose.

Atherosclerosis (more generally known as arteriosclerosis), often called hardening of the arteries, is this country's number-one killer, leading to approximately one million deaths every year. The human and economic costs are staggering. Over forty million Americans suffer from cardiovascular disease alone, with associated costs for treatment estimated to be about $259 billion annually. More than 500,000 coronary bypass operations are performed every year, each costing between $50,000 and $100,000. And strokes and peripheral vascular disease affecting arteries to the legs and kidneys account for billions more in medical expenses. Those who survive the complications of atherosclerosis are frequently physically impaired, and many are no longer able to work or enjoy life.

Millions of people are completely unaware that their blood vessels are 80, or even 90, percent occluded, and, of the 1.5 million heart attacks that occur each year, one-third of those are the first sign most people have of a vascular problem. In cases of such high degrees of occlusion, some form of ill health is inevitable, and short of a heart attack or stroke, other warning problems may manifest. Occluded heart arteries can lead to coronary artery pain (angina), which manifests as chest pain, shortness of breath, or pain radiating into the left arm or jaw that lasts for seconds or minutes. When obstruction occurs in arteries supplying blood to the brain, symptoms may include short periods of weakness or numbness on one side of the body. If vessels on the left side are affected, brief periods of speech difficulty, stammering for words, or inability to understand what someone else is saying may result. These spells are called transient ischemic attacks or TIAs. "Ischemia" means reduced blood supply to a tissue or organ. All these conditions are symptoms of a larger problem, and may eventually lead to a catastrophic event such as a stroke or heart attack.

Over the years, doctors have identified many factors that increase stroke and heart-attack risk. These include: obesity, diabetes, smoking, heavy drinking, chronic stress, chronic illness, a diet high in saturated fats (especially trans fatty acids, mainly the products of partial hydrogenation of vegetable oils), hypothyroidism, hypertension, and the use of oral contraceptives. Recently, the medical profession has begun to realize that certain infectious organisms may also play a role in atherosclerosis.

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