According to the Ministry of Health of the Republic of Bulgaria, cardiovascular diseases are the leading cause of morbidity and mortality both globally and locally. This is a major problem particularly in Bulgaria - statistics show that in our country two out of three people die from cardiovascular diseases, such as myocardial heart attack, stroke, heart failure and others. Atherosclerosis tends to be of great importance and thus may be the primary reason for the development and further complications of cardiovascular disease.
What is atherosclerosis?
Atherosclerosis (arteriosclerotic vascular disease, ASVD) is a form of arteriosclerosis in which the arterial walls thicken. This is a result of the rapid accumulation of white blood cells that are creating a fibro-fatty plaque.
Accumulation of white blood cells is also known as 'fatty streaks' and contains both active white blood cells and dead cells, cholesterol and triglycerides. The remnants include calcium and crystallized material. The fatty streaks reduce greatly the elasticity of arteral walls.
Wall thickening often does not affect blood flow for long periods of time – up to several decades - because of the possibility of the artery wall to enlarge where the plaque is.
Arterial wall stiffening eventually increases the pulse pressure and a widened pulse pressure is one of the most wide-spread outcomes of advanced atherosclerotic disease.
The complications of an advanced atherosclerotic disease are more often than not a chronic, progressive and cumulative condition. Soft plaque suddenly ruptures in many cases and cause formation of a thrombus that rapidly slows or fully stop the flow of blood.
This can lead to death of the tissues that are fed by the artery, and this is a very fast process (it takes approx. 5 minutes after clogging).
This event is called an “infarction”.
One of the most common complications is coronary arterial thrombosis that can cause a heart attack (myocardial infarction).
Similarly – this same process happening in artery that leads to the human brain is known as a “stroke”.
During the atherosclerotic process cholesterol-containing fatty deposits (ie. atherosclerotic plaques) are being formed in vital vessels, supplying blood to the internal organs. The disease can develop at a very early age. Atherosclerosis has a prolonged latent period, which often occurs without active clinical symptoms. Symptoms may occur when the disease is already advanced.
Atherosclerosis can have life-threatening complications such as acute myocardial heart attack, stroke, thrombosis, impaired blood flow, ischemic stroke, arterial blockage and others.
What are the risk factors?
Medicine has a clear understanding of the most common risk factors that can lead to the emergence and accelerate the development of atherosclerotic process.
What risk factors we can not control?
Age
Gender - Men (over 45 years) and women (over age 55) are in the group of patients with increased risk of cardiovascular disease.
Family history
These risk factors can not be controlled. Their presence in some patients increases the risk of cardiovascular disease.
What risk factors we can control?
• Hypertension and high blood pressure
• High cholesterol levels
• Diabetes
• Tobacco smoking and inhaling second-hand smoke
• Obesity
• Prolonged immobilisation
Main characteristics of the atherosclerotic process
The long latency period and knowledge of various risk factors allows for taking various preventive measures.
Ignoring the risk factors can lead to a number of serious complications and to accelerate the atherosclerotic process.
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