aterosclerosis

Atherosclerosis is a chronic disease of the arteries in which lipids and inflammatory material accumulate in the inner layer, forming plaques. These plaques narrow the vessel and can become unstable. Over time, the arteries may lose elasticity and blood flow to organs can be reduced.

The process begins with endothelial dysfunction, allowing low-density lipoprotein cholesterol (LDL) to enter the arterial intima. Macrophages ingest lipids and form foam cells, creating fatty streaks. Inflammation and smooth muscle proliferation produce fibrous, calcified plaques that may grow and partially occlude the vessel or rupture.

Plaque rupture or severe stenosis can restrict blood supply to the heart, brain, legs, or kidneys. In the heart, it can cause angina or myocardial infarction; in the brain, stroke or TIA; in the limbs, claudication or critical limb ischemia.

Risk factors include age, male sex, and a family history, as well as modifiable factors such as smoking, high blood pressure, elevated LDL cholesterol, diabetes, obesity, and physical inactivity. The condition is more prevalent with increasing age and is a leading cause of cardiovascular morbidity worldwide.

Diagnosis involves clinical assessment, lipid testing, and imaging techniques such as ultrasound, computed tomography calcium scoring, or CT/MRI angiography. Management focuses on risk reduction and symptom control: lifestyle changes, statins to lower LDL, antihypertensive and antidiabetic therapies as needed, and antiplatelet agents in selected patients. Revascularization may be considered for significant stenosis.