What causes of atherosclerosis are known to modern medicine? atherosclerosis and diabetes mellitus. Treatment of vascular atherosclerosis

What are the causes of atherosclerosis? Many people think that only the elderly can get sick. But this is far from true. It is necessary to find out the causes of this disease.

What is called atherosclerosis?

The disease is systemic: blood vessels are affected human body, there is a violation of the vessels of the brain. All systems of the body are affected, although the focus can be located in only one or a few departments. The ideal artery is smooth, shiny and even.

The appearance of plaques (growths) on blood vessels causes their narrowing and difficulty in the flow of blood through them. Plaques can grow in "families", grow together later into one growth. You can understand the cause of the occurrence by understanding what cholesterol is. Cholesterol is a complex symbiosis of fat molecules. The classes of compounds of the human body are fats, proteins, carbohydrates, vitamins and more.

Fats are lipids and protein is protein. The intercellular fluid of the blood combines all molecules, including cholesterol. Molecules (fat) are in close connection with protein molecules. They form a protein-fat complex, referred to in science (medicine) as lipoproteins. These complexes (LP) are involved in the formation of plaques. They are also involved in reverse regeneration (disappearance of atherosclerotic plaques). LP as a separate group is heterogeneous. In medicine, special attention is paid to five groups of lipoproteins, three are of greater interest:

• alpha lipoproteins;
• beta lipoproteins;
• pre-beta lipoproteins.

The first group contributes to the elimination of atherosclerosis, but the next two, on the contrary, cause its development. The cause of the disease is a metabolic disorder.

Risk factors and causes of the disease

The factors are divided into the following groups:

• predisposing;
• provoking;
• conducive.

Predisposing to the development of the disease are those factors that we cannot influence. Predisposing to the development of AS will be the following factors. First, it is the genetics of the structure of a separate human body. Scientists have not yet fully studied this mechanism, but, according to statistics, people who have a relative who suffered from hypertension, coronary artery disease, are more likely to suffer from the disease. Secondly, the gender of the person is a predisposing factor. Men are more susceptible to the disease than women. A woman is protected from the occurrence of atherosclerosis up to hormonal changes in the body (menopause) by estrogens.

However, sometimes it is said about the development of atherosclerosis in girls who have a number of bad habits: smoking, alcohol. Taking contraceptives can also affect early atherosclerosis. The third factor is age. The risk of getting sick in men occurs after 35 years. Finally, the last predisposing cause for atherosclerosis is the psychological characteristics of a person. Mobile people are most often ill. The level of cholesterol in the blood can be adjusted by a person. Atherosclerotic plaques are formed in places where cholesterol accumulates, in damaged areas of the vessel.

Cholesterol is the main constituent of plaques. It does not dissolve in the aquatic environment, so subsequently the growths take on an increasingly solid state. It is more and more difficult for blood to move through the vessels. An incorrect current occurs, the consequences of which are the death of blood cells, sticking them together. The plaque is increasing. As a result, a person acquires chronic circulatory failure. And the process of death and gluing, meanwhile, continues. Thrombi grow. As a result of tearing off a blood clot, blockage of an artery can occur, which may lead to death. Hypertension, in other words, high blood pressure, is a risk factor for atherosclerosis.

With increased blood pressure, blood moves faster through the circulatory system, as a result of which not only the condition worsens, but also an increase in the number of platelets destroyed.

Smoking contributes to the development of atherosclerosis. Located in tobacco products nicotine leads to spasms in the vessels of the body. The movement of blood cells worsens, gluing intensifies.

This causes the development of atherosclerosis to progress. It is impossible not to say about the weight of a person. Weight gain also increases the risk of atherosclerotic plaque formation. This is a powerful factor that affects the development of not only atherosclerosis, but also other diseases. Increased body weight leads to stress on the body as a whole, affects all systems. The metabolism is changing. People are not serious about this, and yet malnutrition leads to obesity, and subsequently to atherosclerosis. Such a dangerous disease diabetes contributes to the development of atherosclerosis. Carbon metabolism is disturbed, and all the vessels of the body are affected.

Often, a person diagnosed with atherosclerosis does not even suspect that he has diabetes. However, these two diseases often accompany each other. A thorough examination of the human body is required to exclude or confirm the diagnosis. Provoking factors that affect atherogenesis are stressful situations and bad habits. This has already been discussed above. These two factors provoke the development of AS.

Treatment of atherosclerosis

The disease is of the following types:

• atherosclerosis of cerebral vessels;

To establish the diagnosis, the causes of atherosclerosis should only be a doctor. If the stage of AS development is initial, then a change in lifestyle is recommended: giving up bad habits, observing special diet bringing cholesterol levels back to normal levels.

It is important to visit a doctor at least once every 5 years. If the patient has a high level of risk, lifestyle changes are recommended, re-examination after three months after the modification.

It is necessary to undergo an examination at least once a year. If the risk remains high, drugs are prescribed.

Dieting

Compliance with the diet is recommended for each patient. The doctor takes into account the level of cholesterol, other risk factors and individually prescribes a diet. Food should be different, nutrition - balanced. The daily caloric content must be maintained. The amount of fat consumed should not exceed 30% per day. It is recommended to replace animal fat with vegetable fat. Fruits and vegetables should be at least 400 g per day. It is beneficial to consume low-fat foods, such as poultry meat, cereal baked goods, low-fat cottage cheese, fish rich in omega-3 fatty acids, dairy products. It is recommended to limit your salt intake.

By strictly following the diet, they normalize the level of cholesterol in the blood, thereby eliminating the risk of atherosclerosis. The already existing stage of the disease is brought to normal levels. Each person must take care of himself. We must not forget that life is given once and only a person can prolong it by being responsible for his health.

Stenosing atherosclerosis usually has a widespread character, that is, it affects many vessels at the same time, therefore it manifests itself in a variety of ways. clinical symptoms. This type of atherosclerosis is almost impossible to completely cure, you can only stop the process and restore the lost vascular patency.

Symptoms of stenosing atherosclerosis:

1. Brain symptoms:

• severe headaches that do not go away after taking medicines and after sleep;
• weakness, malaise, sleep disturbance, inattention, impaired concentration, memory impairment, gradually reaching its partial loss, and so on;
• decreased vision, up to its loss;
• slurred speech, in severe cases - skewed facial expressions;
• decreased sensitivity of the skin, paresis of the limbs (paralysis).

3. kidney symptoms characterized by an increase in blood pressure and the development of arterial hypertension.

4. Intestinal symptoms:

• intestinal gangrene (death of tissues of the gastrointestinal tract) - occurs with a complete violation of the blood circulation of the vessels of the mesentery.

Obliterating atherosclerosis of the lower extremities, what is it, what are the symptoms and prognosis?

When the compensatory mechanisms end, there is a complete cessation of blood circulation in a certain area of ​​the lower extremities, as a result - an extreme degree of obliterating atherosclerosis - gangrene, in which it is very difficult to save the limb. Therefore, it is extremely important to identify atherosclerosis of the vessels of the extremities on early stages, because with the help of medication and / or surgical treatment can prevent the development of gangrene.

Symptoms of obliterating atherosclerosis of the lower extremities:

Sections of the aorta:

• ascending aorta;
• aortic arch;
• descending aorta (divided into thoracic and abdominal part);
• aortic bifurcation - the place of bifurcation of the vessel into two iliac arteries that feed the lower limbs.

Any part of the aorta can be affected, and depending on the localization, certain symptoms occur.

Symptoms of atherosclerosis of the ascending aorta, arch and thoracic descending aorta:

• heartache paroxysmal compressive nature, as in angina pectoris, pain can be given to the arms, neck, stomach, back;
• pulsation of visible vessels between the ribs;
• increased blood pressure due to systolic (upper);
• dizziness and fainting;
• hoarseness of the voice, violation of the act of swallowing (with atherosclerosis of the aortic arch);
• rarely convulsive syndrome.

• recurrent abdominal pain;
• violation of the stool - constipation;
• indigestion : heartburn, nausea, heaviness in the abdomen after eating;
• weight loss.

Symptoms of atherosclerosis of the aortic bifurcation:

aortic aneurysm- this is a protrusion of the vascular wall in a place above the section of the vessel blocked by an atherosclerotic plaque.

When blood flow through the aorta is obstructed, a large volume of blood is retained and stretches the vessel wall (containing a large amount of smooth muscle). In this case, over time, the elasticity of the stretched wall is lost and the aortic aneurysm ruptures. Mortality from this complication is very high, it is possible to help a person only with emergency surgical intervention.

Symptoms of a ruptured aortic aneurysm:

• sharp sharp pain in the chest or abdomen;
• a sharp decrease in blood pressure;
• shock, coma, on failure emergency assistance death of the patient in a short time.

• diagnosis of atherosclerosis;
• computed tomography of the chest or abdomen;
• Abdominal ultrasound.

In the presence of an aortic aneurysm in the phase of dissection of the vascular wall (precedes the rupture of the aneurysm) or rupture, they resort to to surgical methods of treatment:

• the affected area of ​​the aorta is removed and replaced with an artificial vessel, or own vessels are transplanted from healthy areas (bypass);
• impose special fabric on the aneurysm area, which prevents its rupture - the operation eliminates the life-threatening condition, but does not radically solve the problem (palliative surgery).

Atherosclerosis in diabetes, why does it occur and how does it manifest itself?

Diabetics are 5 times more likely to suffer from this vascular pathology, both young and old patients. And mortality in this group of patients from complications of atherosclerosis is twice as high as in non-diabetic people.

The course of atherosclerosis against the background of diabetes mellitus is more aggressive, severe, with frequent complications and speed of the process.

For diabetes absolutely all types of vessels can be affected, but most often observed atherosclerosis of such vessels:

• coronary;
• renal;
• vessels of the brain;
• vessels of the fundus;
• arteries and capillaries of the lower extremities.

Impact of diabetes mellitus on the risk of atherosclerosis:

1. Wrong nutrition. People with type 2 diabetes often have an unhealthy diet, high in fat, which in itself increases the risk of developing atherosclerosis.
2. Violation of the regulation of fat metabolism. In diabetes mellitus, a high level of blood lipoproteins (beta fractions) is observed, the synthesis of phospholipids (“useful” fats) is impaired, and a violation of the functions of the liver and pancreas involved in lipid metabolism develops.
3. Malnutrition of the vascular wall against the background of diabetes mellitus, it contributes to an increase in vascular permeability and cholesterol deposition.
4. Violation of oxidation processes in the form of ketoacidosis contribute to the deposition cholesterol plaques and education in it connective tissue and calcium salts.
5. Blood clotting disorder and increased formation of blood clots lead to clogging of vessels affected by atherosclerosis.
6. Specific vascular lesions with diabetes - diabetic angiopathy are also directly related to atherosclerosis.
7. High risk of developing hypertension in diabetics and other diseases of the cardiovascular system, which is the main risk factor for the development of atherosclerosis.

Symptoms of atherosclerosis against the background of diabetes are the same as in non-diabetics, only more pronounced and rapidly developing.

Complications of atherosclerosis in diabetes:

• aneurysms of the aorta and other vessels, their ruptures;
• organ ischemia;
• ischemic heart disease and myocardial infarction;
• diabetic encephalopathy leading to strokes;
• nephropathy and as a result - chronic renal failure;
• angiopathy of the fundus vessels leads to retinal detachment and blindness;
• damage to the lower extremities eventually leads to long-term non-healing trophic ulcers (diabetic foot) and gangrene, which often requires amputation of the legs.

Principles of treatment of atherosclerosis in diabetes mellitus:

• diet and insulin therapy, blood glucose control;
• healthy lifestyle, rejection of bad habits;
• control of blood pressure, treatment of arterial hypertension;
• proper care behind the legs;
• taking cholesterol-lowering drugs, nicotinic acid and other medications for the treatment of atherosclerosis;
• if necessary and possible, surgical methods for the treatment of atherosclerosis.

• control over blood sugar levels, regular and controlled intake of insulin injections;
• proper nutrition, associated not only with the control of carbohydrates eaten, but also fats;
• motor activity (but not heavy physical activity);
• quit smoking, do not abuse alcohol;
• regular monitoring of lipid profile;
• blood pressure monitoring, ECG and so on.

Cholesterol in atherosclerosis, myths and truth

There is a lot of talk about completely cutting out cholesterol. Does exclusion of cholesterol from the diet really have a positive effect on atherosclerosis and on the body as a whole, and cholesterol itself is almost a poison for the body? Let's try to figure this out.

cholesterol (cholesterol)- This is a fat molecule that enters our body with food or is synthesized by the liver from other types of fats. If, with a lack of cholesterol, the body itself begins to produce it, then a person needs it.

Why do we need cholesterol?

• bile components (bile acids) are synthesized from it;
• cholesterol is such a building block for the structure of the cell wall of all types of cells, provides cell permeability for nutrients, ions and other components;
• participates in the absorption of vitamin D, necessary for the growth and strength of bones, as well as many other vitamins;
• some hormones are synthesized from it (sex hormones, adrenal hormones - glucocorticosteroids, and so on).

Cholesterol is useful and harmful. Good cholesterol is found in lipoproteins high density(HDL), and bad, contributing to the development of atherosclerosis, in low and very low density lipoproteins (LDL and VLDL). High-density lipoproteins not only participate in many important processes in the body, but also prevent the development of atherosclerosis by clearing the vessels from atherosclerotic plaques.

In addition to cholesterol, there are fatty acid leading to the formation of atherosclerotic plaque, but not all of them are so harmful. Fatty acids are saturated and unsaturated. So, saturated fatty acids are involved in the development of atherosclerosis, and unsaturated fatty acids, on the contrary, strengthen the vascular cell and help prevent the formation of atherosclerotic plaques.

Therefore, it is not necessary to completely exclude cholesterol and fats from the diet, but it is necessary to eat healthy fats.

Foods with healthy fats:

• many kinds vegetable oil(sunflower, olive, sesame, corn, soy and so on);
• many nuts (peanuts, walnuts, hazelnuts, sesame and others);
• butter;
• avocado;
• fish, especially salmon;
• soy and so on.

Pay attention to your diet, and you can prevent not only atherosclerosis, but also many other diseases (diabetes, obesity, arterial hypertension, gout, etc.).

What vitamins and biologically active substances are needed for atherosclerosis?

Vitamins also play an important role in the treatment and prevention of atherosclerosis. Of course, it is important to balance the diet for all groups of vitamins and trace elements, but there are a number of vitamins that are needed in the first place.

Vitamins that improve the condition of the vascular wall, vascular patency and contribute to the prevention and treatment of atherosclerosis:

1. Nicotinic acid or vitamin PP- dilates peripheral blood vessels, promotes the supply of oxygen to tissues. It is necessary to take dosage forms of nicotinic acid and foods rich in this vitamin :

• grain crops , cereals, whole grain products;
• eggs;
• many nuts and fruit pits, seeds;
• mushrooms;
• seafood;
• poultry meat;
• liver;
• tea and so on.

3. B vitamins(B1, B6, B12, B15 and other representatives of this vitamin group):

• improvement of the nervous system, regulation of vascular tone, participation in the regulation of blood pressure;
• participation in the metabolism of fats;
• participation in the maintenance of normal cellular composition blood.

• cereals, cereals, bran;
• greenery;
• vegetables;
• liver and many other products.

• vegetable oils;
• nuts and seeds;
• mustard;
• vegetables and greens;
• papaya and avocado.

6. Minerals:

• iodine reduces blood cholesterol levels, found in seafood, baked potatoes, cranberries and prunes;
• selenium contribute more quick recovery an organ that has undergone ischemia and hypoxia is found in cereals and cereals, liver, green vegetables, nuts;
• magnesium reduces blood cholesterol levels, improves the functioning of the cardiovascular system, is contained in enough in seafood, cereals, grains, legumes, nuts, many vegetables, and so on;
• chromium participates in the metabolism of fats and contributes to the normalization of blood pressure; foods rich in chromium: fish, liver, pearl barley, beets.

• unsaturated fatty acids (namely, the Omega-3 complex contained in fish oil);
• amino acids (arginine and taurine) found in meat, dairy, eggs, fish, soy, grains, and so on;
• phospholipids (lecithin) - eggs, fish caviar, fish, legumes, grains and more.

- This is a chronic disease of the blood vessels, in which "bad" cholesterol and other LDL are deposited on their inner wall in the form of plaques and plaques, and the walls themselves become denser and lose their elasticity. The vessels gradually become hard due to the settling of fats and lime on the walls, lose their elasticity and, as a result, narrow, which reduces the access of blood to the organs. Eventually, the vessel may close completely. And when this is accompanied by a violation of blood clotting, then there is a tendency to and ischemic damage to organs occurs.

Atherosclerosis is considered one of the most dangerous diseases that leads to death. Atherosclerosis is recognized, most often when problems with the blood supply to the heart, limbs and brain already appear, that is, the disease is diagnosed in the last stages. Atherosclerosis is one of the main causes of the development of cardiovascular diseases: and.

The percentage of people with atherosclerosis increases depending on their age, i.e. this disease is typical for older people. Therefore, doctors call it an senile disease, but every year it gets younger, which is associated with a modern lifestyle.

Symptoms of atherosclerosis

Atherosclerosis is a systemic disease, therefore it usually affects all major blood vessels of the body. It follows from this that the manifestations are also diverse. Suffer, as a rule, the heart, brain, limbs (most often lower). The symptomatology is specific, but it does not always manifest itself clearly enough to unambiguously diagnose atherosclerosis.

Symptoms depend on which organ suffers from lack of blood circulation to a greater extent. In any form of atherosclerosis, two symptomatic periods are distinguished. In the preclinical period, the process is just beginning, so there are no specific manifestations. Significant problems with blood supply and functioning of organs begin when the lumen of the artery closes more than 1/2.

A heart

Pain in the heart occurs with a frequency of 75%. Atherosclerosis affects the coronary vessels and reduces the flow of oxygen and nutrients to the myocardium. - one of the organs most sensitive to changes in the intensity of nutrition. According to this indicator, it is inferior only to the brain. However, the symptoms develop immediately, it is important to correctly interpret the patient's sensations.

Violation of the normal blood supply to the heart is manifested by angina pectoris syndrome.

Heart symptoms occur intermittently and include:

Pain in the chest. Pressing, dull, aching or burning (which is typical for an ischemic process). Pain radiates to the shoulder blade, left forearm, hand or fingers (along the entire length circulatory system);

Sensation of pressure on the chest (as if a heavy weight had been placed on the chest);

Pain when breathing (both inhaling and exhaling);

Respiratory disorders.

Angina pectoris, as a syndrome characteristic of atherosclerosis, manifests itself paroxysmal. Attacks are accompanied by instability of blood pressure levels.

Slightly less common in atherosclerosis coronary vessels appear the following symptoms:

Pain in the lower jaw, ear, neck on the left side (irradiation, but in the opposite direction);

Pain in the back;

Feeling of weakness in the limbs;

Feeling cold excessive sweating and chills ("goosebumps");

Brain

He is most susceptible to malnutrition, however primary symptoms characteristic not only of atherosclerosis. So, problems with cerebral circulation are observed with, vertebrobasilar insufficiency, etc.

Symptoms appear gradually, in increasing order:

Cephalgia (or headache, unspecified). Covers the entire head without the ability to determine the exact localization. Has a bursting or pressing character;

Sleep problems. A person suffers from, or vice versa, he is constantly sleepy. During sleep, severe or nightmare dreams often occur (due to brain activity and diffuse changes due to lack of blood circulation);

Deterioration of a person's character (changes in personality);

Nervousness, high excitability, increased anxiety;

Lethargy and fatigue;

Violations of the basic functions of the body: breathing, speech, nutrition. The person may speak indistinctly, often choke on food, etc.;

Disturbances in coordination of movements, problems with independent movement and orientation in space (due to damage to the cerebellum).

Causes of atherosclerosis

The causes of atherosclerosis are smoking, diabetes, high blood cholesterol. But the main cause of atherosclerosis is a violation of cholesterol metabolism. The formation of atherosclerosis is a natural process that begins at about 10–15 years of age. With age, it can slow down, or it can speed up.

There are the following risk factors for the development of atherosclerosis:

Floor. Men are more prone to developing atherosclerosis than women. The first signs of this pathology can appear already from the age of 45, or even earlier, in women - from the age of 55. Perhaps this is due to the more active participation of estrogens in the metabolism of cholesterol and low and very low density lipoproteins;

Age. This is natural factor risk. With age, atherosclerotic manifestations worsen;

Heredity. Of course, this is one of the causes of atherosclerosis. Atherosclerosis is a multi-causal disease. Therefore, the level hormonal background, hereditary dyslipoproteinemia (impaired plasma lipid profile), activity play an important role in accelerating or slowing down the development of atherosclerosis;

Bad habits. Smoking is a poison to the body. This habit is another reason for the development of atherosclerosis. Wanna have healthy blood vessels- Quit smoking! As for alcohol, there is an interesting relationship: the use of small doses of alcohol - about 50 g of vodka, 100 g of wine or 0.5 liters of beer daily is an excellent prevention of atherosclerosis. True, the same dose contributes to the development of cirrhosis of the liver. So we treat one thing - we cripple another. But large doses of alcohol accelerate the development of atherosclerosis;

Excess weight. This factor increases the likelihood of atherosclerosis. Obesity can lead to, and this pathology is a direct road to atherosclerosis;

Wrong nutrition. Fatty, junk food is a major risk factor. Eating is a very important physiological process in our life. Our future health will depend on how useful the foods we eat are. Few people know that no diet, other than therapeutic and balanced diets, is endorsed by the World Food Hygiene Council. You need to eat rationally and adequately to your needs and energy costs.

The average life expectancy of the Japanese is 90 years, and the Russians - about 60. Why such a difference? The answer is simple: look at what the Japanese and others eat. Eastern peoples. Their menu includes various grains, vegetables, herbs, beans and fresh fish. Every day, the market in Tokyo is filled with seafood that contains valuable fatty acids. Why treat a disease if it is easier to prevent it? Start eating right early age to say thank you to myself in my old age.

Video: atherosclerotic plaque formation

Types of atherosclerosis

Atherosclerosis of the heart vessels ( coronary arteries). Promotes the development of coronary artery disease, angina pectoris and heart attack;

aortic shape. The aorta is the largest artery in the body. Its defeat by atherosclerosis significantly affects all organs and systems;

Atherosclerosis of the renal vessels. Lack of blood circulation leads to impaired renal function and severe arterial hypertension;

Atherosclerosis of vessels that provide blood supply to the brain;

Atherosclerosis of the vessels of the lower and upper extremities.

Forms can appear independently, but more often they do it systematically.

Cholesterol levels and atherosclerosis

Cholesterol is a special chemical compound, by its nature - a fatty alcohol. The role of cholesterol in the synthesis of cellular structures and organelles has been proven (cholesterol is known to be involved in the formation cell membranes). However, an increase in the level of a substance in the blood directly increases the risk of developing atherosclerotic pathology and other diseases of the cardiovascular system, since it indicates the onset of lipid and lipoprotein metabolism disorders in the body.

To prevent the development of this formidable disease is possible only by giving up bad habits and maintaining the concentration of fatty alcohol in the blood at the same normal level all the time. However, cholesterol is atherogenic only in excess.

Its normal content is necessary not only for the performance structural function, but also:

For normal digestion. With the participation of fatty alcohol in the liver, the digestive juices necessary for the processing of fat-containing compounds are synthesized;

For stable synthesis of sex hormones and pancreatic hormones.

Cholesterol enters the bloodstream in several ways:

Synthesized by the liver. The liver produces the most cholesterol. Usually, its more active production is associated with a deficiency of the compound and the inability to replenish it with cholesterol from food. With impaired liver function, interruptions and problems with the regulation of the level of a substance in the blood are also possible;

Comes with food. Such cholesterol is not more than 25%. Cholesterol is found in foods containing animal fats. Its highest concentration is observed in egg yolks, offal (brains, liver, kidneys), shrimp, margarine, bacon. The cholesterol contained in them enters the blood in a free state and only then is transferred by chylomicrons to the liver, where, depending on functional features The body and the usual diet turns into lipoprotein complexes of two types: “good” (or HDL) and “bad” (LDL). The former clean the walls of blood vessels from layers of fat, and the latter form them.

In addition to the fact that cholesterol is actively synthesized and used by the body, it is also actively removed from it. Most connection comes out natural way through digestive tract. A slightly smaller amount is excreted through the death (desquamation) of the upper layers of the skin and intestinal mucous membranes.

An elevated level of cholesterol in the blood proportionally increases the risk of developing atherosclerosis - such a phrase can often be heard, but is it really true? . The norm of cholesterol in the blood is far from a guarantee and not insurance against the formation of pathology for other reasons.

Atherosclerosis is directly related to the presence of concomitant diseases (neuroendocrine form of hypothalamic syndrome, diabetes mellitus, dependence on psychoactive substances, etc.). They act as equivalent risk factors for the development of the disease.

One way or another, but cholesterol plays one of the key roles in the development of atherosclerosis. To reduce the risk, it is necessary to adhere to a hypocholesterol diet and maintain the concentration of the substance at approximately the same normal level.

atherosclerosis and diabetes

Cholesterol is actively involved in the synthesis of digestive juices and pancreatic hormones, and, despite the fact that it is not the cause of diabetes, it still significantly affects the course of the disease.

Diabetes mellitus is considered an increased risk factor for the development of atherosclerosis of the vessels (more than half the likelihood of development increases). Atherosclerosis also increases the severity of diabetes. In the presence of diabetes mellitus, the incidence of atherosclerosis is set at equal boundaries in both men and women (although without diabetes, men are more likely to get sick).

Diabetes mellitus, in turn, seriously complicates the course of atherosclerosis:

Atherosclerosis can develop in young age if you have diabetes. Although usually the disease develops after 45-50 years;

The likelihood of aneurysms is high;

The vessels not only become clogged, but also become extremely fragile, and therefore the likelihood of strokes increases;

The process becomes systemic, equally severely affecting the heart, brain, and limbs.

Atherosclerosis begins in both type 1 diabetes and type 2 diabetes. Diabetes is associated with impaired digestion and lipid metabolism, which causes a stop in normal metabolism. The walls of blood vessels acquire an excessively increased permeability for fatty fractions, and therefore much more “bad cholesterol” penetrates into the bloodstream. It forms fat deposits on the walls of large arteries, gradually closing the gaps of the highway.

Over time, the stratification of fat is encapsulated by connective tissue and crystallized under the influence of calcium deposits. This whole structure becomes "stony" and the lumen of the artery closes even more. The vessel becomes brittle and loses its conductive function. The result is a violation of blood circulation in the affected area, increasing ischemia, rupture of the vessel and tissue necrosis.

Patients with diabetes mellitus are 4 times more likely to suffer from concomitant diseases of the cardiovascular system, such as hypertension, coronary heart disease and angina pectoris. In addition, with atherosclerosis in diabetics, the likelihood of rapid development of necrosis (gangrene) of the lower extremities increases almost seven times. These factors must be considered in treatment.

Why is atherosclerosis dangerous? Stages of development

According to statistics, atherosclerosis is the most common disease of the cardiovascular system and the main cause of death for the vast majority of patients around the world. Atherosclerosis is variable, and despite the fact that the essence of the disease is the narrowing or blockage of blood vessels, it significantly affects the entire body. Circulatory failure affects the heart, brain, abdominal organs, lower and upper (rarely) limbs. Disturbances in blood flow in the arteries also affect smaller blood vessels, causing secondary ischemia.

Atherosclerosis is a polyetiological disease. Until the end, the specific causes are unknown, but it is known that the mechanism is based on a violation of lipid metabolism. This dysfunction is the trigger for the onset of a dangerous disease.

There are several stages in the development of pathology:

Stage of formation of spots of fats (or lipid spots). At this stage, no specific symptoms are observed, and the patient does not suspect the presence of atherosclerosis. The essence of the stage lies in diffuse changes in the walls of the arteries (molecules of lipoprotein complexes penetrate into the structure of the arterial wall and form thin layer). Outwardly, these changes look like yellowish-brown stripes along the length of the affected area of ​​the vessel. Not the entire tissue of the bloodstream is affected, but only individual segments. The process is developing quite quickly. It is accelerated by already existing cardiovascular pathologies, diabetes mellitus and obesity;

The stage of formation of lipid stratification. The tissue under the lipid bands becomes inflamed. The body thus tries to fight the imaginary intruder. A long-term focus of chronic inflammation is formed. Constant inflammation leads to the decomposition of the lipid layer and the germination of tissue. As a result, the fat accumulation is encapsulated and rises above the wall of the artery;

Stage of development of complications. This is last stage in the development of atherosclerosis. At this stage, complications develop, and the symptoms are most pronounced. There are two main options for complications: rupture of encapsulated fatty deposits (plaques), which entails the release of a large amount of blood, and thrombosis. Thrombi, together with plaque products, get stuck in the lumen of the vessel, finally clogging it. In such a situation, the development of a stroke is possible. If blood clots clog large arteries that provide the necessary nutrition to the limbs, tissue necrosis and gangrene are most likely to occur.

It is quite difficult to predict the term and the rapidity of the development of atherosclerosis. It could be years or a matter of months. It all depends on the characteristics of metabolism, metabolic rate, the presence of a predisposition to atherosclerosis and diseases that increase the risk of its development, and many other factors.

Diagnosis of atherosclerosis

Diagnosis of advanced atherosclerosis is relatively easy. It is quite another matter to clarify the localization of the process and accurately determine the lesion. For this, a lot of work needs to be done. Only an experienced doctor can cope with such a difficult task.

Diagnostic measures include:

Collection of anamnesis;

Initial inspection patient using special functional tests;

Laboratory analyzes and instrumental studies. Thanks to them, it is possible to establish the very fact of the presence of the disease, to determine the stage and localization of the process, to assess the general condition of the patient's body.

Collection of anamnesis

Primary Analysis the patient's condition begins with his questioning about complaints and heredity.

Firstly, with this pathology, there will be at least three specific symptom, to everything else, with a high degree of probability there will be signs (and maybe a confirmed diagnosis) of a disease provocateur of atherosclerosis.

Among them:

Arterial hypertension;

Previous myocardial infarction or stroke;

Angina pectoris syndrome, coronary artery disease;

Such diagnostics does not give a complete picture, however, it allows in general terms determine the state of the body and draw up a plan of diagnostic measures.

In addition, it is important to establish the presence of risk factors for the development of atherosclerosis: diabetes mellitus, hypertension, substance use, obesity.

Initial inspection

In addition to functional tests aimed at assessing the blood supply to the limbs, an experienced doctor pays close attention to the following factors:

disappearance hairline on the legs or arms;

Sudden weight loss of the patient;

Murmurs in the heart, increased pressure, disturbances heart rate;

Hyperfunction of sweat and sebaceous glands;

Deformation of nails;

Constant development of edema in the absence of kidney disease.

Laboratory and instrumental methods

Donating venous blood to assess indicators such as atherogenic coefficient, total cholesterol;

X-ray examination and angiography. X-ray allows you to assess the condition of the aorta, since the plaques are clearly visible on the pictures. Angiography is the introduction of a special contrast medium and further monitoring of blood flow;

ultrasound. Allows you to evaluate the speed of blood flow in a particular part of the artery. Thanks to this method, the slightest deviation can be detected and the degree of blood supply deficiency can be determined.

There are other ways to diagnose. Specific methods are determined by the doctor, based on the clinical picture.

Modern methods of treatment

As a rule, in 80% of cases, drug therapy is sufficient to eliminate the cause of atherosclerosis and its detrimental consequences. Treatment with special preparations is combined with the appointment of a diet and an optimal regimen. physical activity.

Among the drugs for atherosclerosis, drugs of several groups can be distinguished:

Statins. The most popular drugs of the statin group are still used. Their action is to inhibit the function of the liver to produce cholesterol. In parallel with statins, patients with atherosclerosis are prescribed medications to maintain the activity of the heart and digestive organs (since statins have the most negative effect on them). At the present stage of the development of medicine, reputable scientists and practitioners question not only the effectiveness of statins, but also the very fact of the role of cholesterol in the development of atherosclerosis, considering the danger of this substance unreasonably high. ;

LC sequestrants. Significantly inhibit the function of the synthesis of bile acids by the liver. In this regard, the body has to actively consume cholesterol in order to ensure normal and stable digestion. Prolonged use may cause disturbances digestive system. They are prescribed at the initial stage of the disease or for the prevention of pathology;

Fibrates. Destroy neutral fatty structures - triglycerides. They are quite effective in the fight against atherosclerosis, but are categorically contraindicated in people with liver problems;

Nicotinic acid preparations. Despite the fact that they do not fight cholesterol, they have a vasodilating and antispasmodic effect. They are used in combination with other drugs and form an important part of drug therapy. However, diabetics and people with liver and gallbladder diseases, nicotine is contraindicated. They are replaced by individual specialized vasodilating and antispasmodic drugs.

Conservative therapy also includes physiotherapy. This method is indicated for persons with atherosclerosis of the extremities.

Surgery

In modern medical practice three main methods of surgical treatment of atherosclerosis have been developed.

Highly invasive:

Shunting. The essence of shunting is to suture the affected vessel to a healthy one, due to which a new blood line is formed, and the blood supply to the tissues is gradually restored;

Vascular prosthetics. Modern materials make it possible to completely replace the affected vessel and restore blood supply functions.

Minimally invasive method:

Angioplasty. The essence of the method is the introduction of a specialized catheter through the femoral artery, which, under the control of the camera, moves along the bloodstream by the endoscopist to the affected area. After that, the necessary manipulations are performed to clean or expand the vessel.

Thus, atherosclerosis is an extremely controversial and complex disease, which, however, requires maximum attention, since it can lead to life-threatening and health-threatening consequences. The symptoms of the disease are quite pronounced, and with the proper level of training, the doctor will easily establish a diagnosis, as well as determine the localization of the process and prescribe a competent and effective treatment. A wide arsenal of tools and methods for diagnosing atherosclerosis, even in the early stages, helps the doctor in this. The specialist will establish a specific examination strategy himself, based on their appropriateness and the degree of confidence in the diagnosis.

Treatment of atherosclerosis at the present stage of development of medicine is not very difficult. In the vast majority of cases, it is possible to get by with “little blood”. If a conservative methods treatment of proper effectiveness is not provided, they resort to surgical intervention.

Correct and competent diagnosis in conjunction with an effective course of treatment is the key to a favorable outcome.

Prevention of atherosclerosis

First of all, this is smoking cessation, weight regulation, certain food restrictions, increased physical activity:

Regulation of body weight in atherosclerosis is a necessary measure, since obesity causes vascular complications and is characterized by impaired lipid metabolism. Low-calorie, optimal fat diets and physical activity are recommended for weight loss;

Physical activity should be increased according to general health and age. You can start it with the safest and most affordable type of physical activity - walking. Classes should be at least three to four times a week for 35-40 minutes.

Conversation with Vyacheslav Artashesovich Isaev - President of the BAA Association, Academician of the Russian Academy of Natural Sciences, Doctor of Biological Sciences, Professor. Topic of the program: Issues of aging. What is atherosclerosis and when does it start? Ways to prevent atherosclerosis:

Education: Moscow medical institute them. I. M. Sechenov, specialty - "Medicine" in 1991, in 1993 " Occupational diseases", in 1996 "Therapy".

Atherosclerosis of the vessels is a disease characterized by the deposition of cholesterol on the walls of blood vessels. Men 50-60 years old and women over 60 years old are most often affected by this disease. Among the most common diseases are atherosclerosis of the vessels of the neck, kidneys, brain, heart and

As you know, cholesterol is a substance that is part of many fats, so its presence in the human body is simply necessary. But this applies to cases where the norm is not exceeded. After all, if there is an increase in cholesterol in the blood, then this entails its gradual deposition on the walls of blood vessels. This mainly happens with the consumption of food that is rich in them, with the occurrence of neuropsychiatric disorders or with a decrease in the function of sexual and thyroid gland. Over time, connective tissue forms around these plaques and a gradual deposition of lime begins. At this point, a disease such as atherosclerosis of the vessels occurs.

Sometimes there is a destruction of atherosclerotic plaques, on the coating of which a small defect appears. As a result, platelets begin to adhere to it, which form blood clots. When part or all of the thrombus is torn off, the lumen of the vessels is clogged, leading to the cessation of blood flow, and then, sometimes, to death.

Symptoms:

• arterial hypertension;
• pain in the muscles of the legs;
• angina attacks;
• heart failure;
• neurological disorders (for example, stroke);
• kidney failure;
• myocardial infarction.

Causes

Currently, vascular atherosclerosis does not have a pronounced cause of its occurrence. Although it has been proven that lifestyle plays a huge role in the development of the disease.

The main factors provoking atherosclerosis of the vessels include:

• smoking;
• alcohol consumption;
• passive lifestyle;
• malnutrition;
• emotional depression;
• overload;
• stress.

Diagnostics

For precise setting diagnosis, the following research methods are used:

Treatment

Must be complex. First of all, you should pay attention to your diet, especially for people prone to obesity. Fats of animal origin, sweets and smoked meats should be limited, which, by the way, are recommended to be completely excluded. But fruits should be consumed in unlimited quantities.

Atherosclerosis is quite common chronic disease characterized by its own progression. Atherosclerosis, the symptoms of which appear against the background of lesions of medium and large arteries due to the accumulation of cholesterol in them (which determines the cause of this disease), causes circulatory disorders and a number of serious risks provoked by this disorder.

general description

With atherosclerosis, atherosclerotic plaques form on the walls of blood vessels (they are based on body fat in combination with growing connective tissue). Because of these plaques, narrowing of the vessels and their subsequent deformation occur. These changes, in turn, lead to impaired blood circulation, as well as damage to internal organs. Basically, large arteries are affected.

Let us dwell in more detail on the picture of this disease. First of all, we note that the occurrence and subsequent formation of atherosclerosis depends on the following factors:

• the state in which the vascular walls are located;
• the relevance of the genetic hereditary factor;
• disorders in fat (lipid) metabolism.

Initially noted cholesterol refers to fats, with its help a number of different functions are provided in our body. In other words, it can be considered as a building material used in cell walls. In addition, cholesterol is a component of vitamins and hormones, due to which adequate vital activity of the body is ensured. Cholesterol is synthesized by about 70% of its total amount in the liver, while the remaining part of it enters the body through food.

Note that cholesterol in the body is not in a free state, it is included in the composition of specific complex compounds of fats and protein - lipoproteins. Lipoproteins, in turn, provide the possibility of its transfer from the liver to the tissues through the bloodstream. If the cholesterol in the body is in an excessive state, then from the tissues it goes to the liver, and it is here that the excess amount is utilized. Violation of the functioning of this mechanism leads to the development of the disease we are considering, that is, atherosclerosis.

In the development of atherosclerosis, the main role is assigned to low-density lipoproteins, in an abbreviated form, this is LDL. At their expense, cholesterol is transported from the liver to the cells, while a strictly defined amount of it is subject to such transportation, otherwise an excess of the level determines a serious risk for the possible development of atherosclerosis against this background.

As for the return transport of cholesterol from tissues to the liver, it is already provided by high-density lipoproteins, which in an abbreviated version defines them as HDL, a separate class of anti-atherogenic lipoproteins. They provide cleansing of the surface layer of cells from excess cholesterol. The risk of developing atherosclerosis occurs with a reduced level HDL cholesterol and elevated LDL levels.

Let us dwell on the age-related features of atherosclerosis. So, it can be noted that the initial type of changes within the walls of the arteries (their medium and large caliber) are already noted at a young age. Subsequently, their evolution occurs, in which they are transformed into fibroadenomatous plaques, which, in turn, often develop after the age of 40 years. The specified atherosclerotic vascular lesion is actual in about 17% of cases in patients under the age of 20 years, in 60% - under the age of 40 years, in 85% - in the age of 50 years and older.

In the future, the picture of the disease is as follows. The arterial wall undergoes penetration into its base of fibrin, cholesterol and a number of substances, due to the influence of which an atherosclerotic plaque is formed. Being in excess, cholesterol, when exerting an appropriate effect, causes an increase in the plaque in size, due to which there is an obstacle to adequate blood flow through the vessels in the area of ​​​​the formed narrowing. Against this background, blood flow decreases, inflammation develops. Blood clots are also formed, they can subsequently come off, thereby determining a significant danger to the vessels that are vital in our body. This is due to the possibility of their blockage, because of which, in turn, the organs will be deprived of the blood supply they require.

Causes of atherosclerosis

The causes of atherosclerosis can be very different, they are also equated with risk factors for the development of atherosclerosis, which indicates that the compliance of conditions with these factors increases the risk of possible development of atherosclerosis in patients. In general, such risk factors can be divided into two main groups, depending on the nature of the impact on them by the patient himself. Thus, the causes of atherosclerosis can be changeable and unchangeable (modifiable and non-modifiable).

Immutable (non-modifiable) reasons, as can be determined already from their name, it is impossible to change by certain measures of influence (including medical ones). These factors include the following:

• Floor. This factor is considered as an independent risk factor in considering the development of atherosclerosis. Atherosclerosis in men develops about 10 years earlier, which is known on the basis of certain statistical data on this subject when compared with female incidence. In addition, before the age of 50, the risk of developing this disease in men is four times higher than, respectively, in women. When the threshold of 50 years of age is reached, the incidence in both sexes is equalized. This feature is explained by the fact that female body from this period, specific hormonal changes begin, and the protective function provided by estrogens disappears (here, as you can understand, we are talking about menopause and a gradual decrease in the intensity of the release of these estrogen hormones).
• Age. As the reader may have already noticed, with age, the risk of developing the disease we are considering increases. Accordingly, the older the person, the greater this risk. And, of course, it is also impossible to influence this factor, because it is considered in this group of them. It should be noted that in general, atherosclerosis as a disease is often compared with the aging of the body, that is, as one of the manifestations of this process. This is explained by the fact that atherosclerotic changes after the transition beyond a specific age period are determined in absolutely all patients. And, as already noted, from the age of 45-50, the risk of such changes especially increases.
• genetic predisposition. This risk factor is also unchanged when considering atherosclerosis. Thus, those patients whose closest relatives are diagnosed with one or another of its forms are especially susceptible to this disease. It is generally accepted that genetic predisposition(it is also heredity) also acts as such a factor, due to which the relative acceleration of the development of atherosclerosis is determined (up to the age of 50). Meanwhile, in people whose age exceeds the mark of 50 years, the factor of heredity in practice determines a slight influence on the development of atherosclerosis, therefore, it is impossible to give a clear statement regarding the early development of this disease if relatives have it.

Changeable (modifiable) reasons, in turn, are characterized by the fact that they can be influenced by the patient. This may include lifestyle adjustments, treatment, etc. Let us single out the options that are relevant for the disease under consideration:

• arterial hypertension. This cause (factor) is independent in considering the development of atherosclerosis. The peculiarity of the impact of hypertension is that against its background there is an increase in the intensity of impregnation of arterial walls with fats, which, in turn, is considered as the initial stage in the development of the main manifestation of atherosclerosis, an atherosclerotic plaque. At the same time, atherosclerosis, due to which the elasticity of the arteries is subject to change, is a factor that increases the risk of developing hypertension in a patient.
• Smoking. This factor is a serious help for the development of many diseases, and atherosclerosis is no exception. With prolonged smoking, the risk of developing the hypertension discussed above, as a predisposing factor in the development of atherosclerosis, increases, which already allows us to trace the chain of changes that are relevant in this case. In addition, smoking also contributes to the development of CHD (coronary heart disease) and hyperlipidemia, which also accelerates the development of atherosclerosis in smokers. The basis of influence is based on the negative impact that the components have. tobacco smoke directly to the vessels.
• Obesity. Another, no less significant factor in the influence, contributing to the development of atherosclerosis. Again, obesity predisposes not only to the development of atherosclerosis itself, but also to one of the factors already listed by us, arterial hypertension, which in any case, as can be understood, links this factor with the disease we are considering. In addition, we note that obesity is also one of the main factors in the development of diabetes mellitus, which also plays an important role in considering the modifiable factors of interest to us.
• Diabetes. The relevance of this factor for patients significantly increases the risk of developing atherosclerosis (approximately 5-7 times). Such a high risk is explained by the relevance of metabolic disorders (in particular, this applies to fats), which provokes the development of atherosclerotic changes in the vessels.
• Hyperlipidemia (dyslipidemia). This factor implies a violation in the metabolism of fats, which determines its no less significant role in terms of considering factors provoking atherosclerosis. It should be noted that all of the above factors are directly related to dyslipidemia, that is, with each of them, the problem of impaired fat metabolism is relevant. The main role in the development of atherosclerosis (as well as other types of diseases associated with the cardiovascular system) is given to the following forms of fat metabolism disorders: elevated cholesterol, elevated triglycerides and elevated levels of lipoproteins in the blood.
• Features of nutrition. The development of atherosclerosis in particular is affected by the presence of a significant amount of animal fats in the diet.
• Hypodynamia (sedentary lifestyle). This factor also plays an important role in the development of atherosclerosis, including the development of the previously listed conditions (diabetes mellitus, arterial hypertension, obesity). Due to reduced motor activity, as you might guess, the processes of carbohydrate and fat metabolism are disrupted, due to which, accordingly, the risk of developing these disorders and atherosclerosis in particular increases.
• Infections. The infectious nature of the development of atherosclerosis has been considered relatively recently. On the basis of ongoing studies, it was found that cytomegalovirus and chlamydial infections can be considered as two options representing this item in its connection with atherosclerosis.

Atherosclerosis: stages

As we have already highlighted, pathological process, relevant for atherosclerosis, is concentrated within the walls of the arteries. This, in turn, leads to the gradual destruction of the affected wall. In accordance with the degree of damage and its features, 3 stages of atherosclerosis are determined sequential in their manifestation, we will consider them below.

• I stage. As part of its manifestation lipid spots form. This implies the impregnation of the walls of the arteries with fat molecules, the localization of the impregnation is noted in this case only within the limited sections of the walls. These areas appear as yellowish stripes concentrated along the entire length of the affected artery. The features of this stage are characterized by the fact that the symptoms of atherosclerosis as such do not manifest themselves, and in general there are no specific disorders due to which it would be possible to determine the relevance of a violation of circulation in the blood arteries. The acceleration of the formation of lipid spots can occur due to the influence of the modifiable factors discussed above in the form of obesity, arterial hypertension and diabetes mellitus.
• II stage. This stage is also defined as the stage of liposclerosis, characterized by the development of atherosclerosis to a stage in which inflammation of lipid spots occurs, which leads to the accumulation of cells of the immune system in their cavities. In particular, they attempt to cleanse the arterial wall from fats that have had time to deposit on it (in some cases, these may be microbes). Against the background of a prolonged inflammatory process, the fats deposited on the arterial wall begin to decompose, and at the same time, the germination of connective tissues in it occurs. This leads to fibrous plaque formation which determines this stage. The surface of such a plaque is in a somewhat elevated position relative to the inner surface of the affected vessel, due to which, thus, its lumen is narrowed, and blood circulation is also disturbed.
• III stage. This stage is the final stage in the development of atherosclerosis, it is characterized by the development of a number of complications, directly related to the development of fibrous plaque. In addition, it is from this stage of the disease that its symptoms begin to appear. This stage is defined as the stage of atherocalcinosis. The progression of the plaque deformation at this stage is determined by the compaction relevant to it, as well as the deposition of calcium salts in it. The nature of the manifestation of an atherosclerotic plaque can determine both its stability and gradual growth, due to which it will continue to deform the lumen of the artery and narrow it. Against the background of this latter option, in turn, the development of a progressive form of a chronic disorder in the blood supply of the organ that feeds on the affected artery will be provoked. This also causes a significant risk of the formation of occlusion (an acute form of blockage), in which the lumen of the vessel is blocked either by a thrombus or an element of plaque decay, as a result of which the blood-supplying organ or limb undergoes a different type of lesion against this background - in the form of the formation of a site of necrosis (infarction) or gangrene.

Atherosclerosis: symptoms

Predominantly affected by atherosclerosis is the aorta (abdominal and thoracic), mesenteric, coronary and renal arteries, as well as the arteries of the brain and lower extremities.

As part of the development of the disease, its asymptomatic (or preclinical) period and the clinical period are distinguished. The asymptomatic period is accompanied by high content beta-lipoproteins in the blood or high levels of cholesterol in it, while there are no symptoms, as can be understood from the definition of this period.

As for the period clinical manifestations, then they are relevant when the arterial lumen is narrowed by 50% or more. This, in turn, determines the relevance of the three main stages of the period: ischemic stage, thrombonecrotic stage and fibrous stage.

Ischemic stage It is characterized by the fact that with it the blood supply to a certain organ is disturbed. As an example, we can highlight the picture of the course of this stage, in which myocardial ischemia against the background of atherosclerosis of the coronary vessels manifests itself in the form of angina pectoris. Stage thrombonecrotic characterized by the addition of thrombosis of arteries that have undergone changes. Atherosclerosis of the coronary arteries in this case can in its own course reach complications in the form of myocardial infarction. And finally fibrous stage, which is characterized by the proliferation of connective tissue that occurs in inefficiently supplied organs. Again, when considering atherosclerosis of the coronary arteries at this stage, one can distinguish the transition to the development of such a pathology as atherosclerotic cardiosclerosis.

As for the specific manifestations of atherosclerosis, its symptoms are determined based on which type of artery has been affected. Below we consider the main variants of the course of this disease.

Atherosclerosis of the aorta: symptoms

Atherosclerosis of the aorta is the most common variant of the manifestation of atherosclerosis, respectively, in most patients it is revealed. Atherosclerosis can affect its various parts, on the basis of which, in turn, the symptoms of the disease and the prognosis for it are determined.

As you probably know, the aorta is the largest blood vessel in our body. It starts from the heart (left ventricle), then branches, thus forming many small vessels that spread to the tissues and organs of our body. The aorta consists of two main sections, which are located in anatomically different areas. The abdominal and thoracic aorta act as such departments.

The thoracic aorta in the aorta is the initial site, due to which the blood supply to the upper part of our body is provided, respectively, these are the organs of the chest itself, neck, head and upper limbs. As for the abdominal aorta, it is the final site; blood supply is provided through it for the abdominal organs. In turn, its final section is divided into two main branches, which are the left and right iliac arteries, through which blood flows to the lower limbs and to the pelvic organs.

In atherosclerosis of the aorta, the lesion, which is relevant for this disease, covers either the entire aorta along its length, or its individual areas. The symptomatology in this case is also determined depending on where exactly the pathological process is localized and how pronounced the changes that have arisen in the walls of the aorta under its influence have become.

Aortic aneurysm is the most dangerous complication provoked by aortic atherosclerosis. With an aortic aneurysm, a certain section of the artery expands, which is accompanied by thinning of the vessel wall and an increased risk of rupture of the artery, which, in turn, can lead to life-threatening bleeding.

Atherosclerosis of the thoracic aorta: symptoms

For a long time, there are no symptoms. Often, atherosclerosis of this department develops along with such forms of the disease as atherosclerosis of the coronary arteries of the heart (i.e. coronary arteries), as well as atherosclerosis of cerebral vessels.

The manifestation of symptoms is observed mainly at the age of 60-70 years, which is explained by the significant damage to the walls of the aorta by this time. Patients complain of burning pain in the chest area, systolic blood pressure rises, swallowing becomes difficult, dizziness is relevant.

as less specific manifestations symptoms may be noted early aging, which is compatible with early appearance gray hair. At the same time, there is an abundance of hair growth in the area of ​​​​the auricles, a characteristic light strip appears along the outer edge of the iris, and wen appear on the skin of the face.

Atherosclerosis of the abdominal aorta: symptoms

This form of the disease is diagnosed in almost half of the cases of all possible variants of its manifestation. Similarly to the previous form, for a long time it may not manifest itself at all.

Atherosclerosis of the area under consideration acts as a reason for the development in patients of such a pathology as abdominal ischemic disease. It, similarly to IHD (ischemic disease), is characterized by the fact that it leads to impaired blood supply against the background of atherosclerosis of vessels, which is particularly relevant for those organs that these vessels feed.

Symptoms associated with a lesion of the abdominal aorta can manifest themselves in the following:

• Stomach ache. Such pains occur after eating, the nature of the manifestation is paroxysmal, aching. As a rule, they are not too intense, they do not have a clear localization. Such pains disappear in a few hours on their own.
• Digestive disorders. In particular, complaints of bloating, the appearance of constipation and diarrhea (alternation of conditions) and a decrease in appetite are relevant.
• Weight loss. This symptom is progressive, caused by a stable form of indigestion.
• Arterial hypertension (high blood pressure), renal failure. Increased blood pressure is due to the fact that the blood supply to the kidneys is subject to violation. As for renal failure, it develops due to the fact that gradually their normal tissues begin to be replaced by connective tissues. This, in turn, determines their gradual necrosis against the background of insufficient blood supply.
• Thrombosis of the visceral arteries. This complication is deadly in atherosclerosis of the considered part of the aorta, moreover, it requires the urgent provision of specialized medical care. With the necrosis of the vessels, due to which the blood supply to the intestine is ensured, its loops become dead, which leads to massive inflammation of the organs concentrated in the abdominal cavity and in the peritoneum (which determines peritonitis). The symptoms of this condition include severe pain that does not disappear when taking antispasmodics and painkillers. In addition, a sudden deterioration in general well-being soon joins the pain.

Atherosclerosis of cerebral vessels: symptoms

This form of atherosclerosis is no less common; in this case, the intracranial and extracranial vessels that feed the brain are subject to damage. The severity of symptoms is determined based on the degree of damage to these vessels. Due to atherosclerosis of the cerebral vessels, the activity of the nervous system is gradually inhibited, mental disorders or a stroke may develop.

The first manifestations of the symptoms of this form of atherosclerosis are diagnosed at the age of 60-65 years of patients, while their interpretation is reduced in most cases only to manifestations of signs of aging. However, this belief is only partly correct. Aging itself is irreversible. physiological process, while atherosclerosis acts as a specific type of disease, the course of which, until it reaches certain limits, determines the possibility of a cure, as well as the implementation of certain preventive measures against it.

Now let's move on to symptoms. The initial manifestations of atherosclerosis of this form are episodic attacks of "ischemic attack", within which relatively stable neurological symptoms appear. This includes, in particular, violations of sensitivity, which can manifest itself either in its decrease on one side of the body, or in complete loss. There are also movement disorders in the form of paresis (partial loss of muscle strength) and paralysis. In addition, there may be hearing, vision and speech impairments. The listed symptomatology, meanwhile, manifests itself within a short time period, after which it disappears.

With a pronounced form of manifestation of atherosclerosis of the cerebral vessels, a stroke often develops, in which there is a necrosis of a certain area of ​​brain tissue. This condition is characterized by a persistent manifestation of the symptoms that we have already considered (loss of sensitivity, paralysis, loss of speech), it can be treated to a small extent.

As other manifestations of the symptoms of atherosclerosis of this form, one can note a disorder of higher nervous activity in one form or another (in particular, this applies to intellectual abilities and memory), changes in character (pickiness, capriciousness, etc.), sleep disturbances, the development of depressive states.

Lack of adequate treatment can lead to dementia ( senile dementia). It, in turn, is a severe and, unfortunately, an irreversible manifestation of a decrease in the higher functions inherent in the brain.

Stroke is the greatest danger of this disease. This condition is essentially a condition similar to myocardial infarction, a condition in which tissue necrosis occurs. This condition is accompanied by increased mortality, as well as frequent disability of patients.

It should be noted that in some cases, symptoms indicating atherosclerosis of the arteries of the brain can be quite difficult to differentiate, for example, from symptoms that manifest themselves in hypertensive encephalopathy or from actual disorders of cerebral blood supply due to the development of spinal diseases of a degenerative scale (for example, osteochondrosis). In fact, it often happens that in patients of the group old age many of the diseases that could be confused with atherosclerosis are relevant, therefore, the diagnosis of this disease determines the need for integrated approach to this process.

Atherosclerosis of the vessels of the lower extremities: symptoms

Similar to the forms we considered earlier, atherosclerosis of the lower extremities (atherosclerosis obliterans) does not manifest itself for a long time, and this lasts until the blood circulation through the vessels is seriously disturbed against the background of the disease we are considering.

As a classic, one might say, symptom, in this case, pains that occur when walking in the muscles of the lower extremities are considered. This symptom has a definition corresponding to its manifestation - “intermittent claudication” (which is explained by periodic stops while walking due to pain that occurs to reduce their intensity). Pain occurs in this case due to the fact that there is a lack of oxygen in the functioning muscles, which, in turn, occurs due to the specifics of atherosclerosis itself.

It is noteworthy that arterial insufficiency that occurs with this form of atherosclerosis negatively affects not only the functions characteristic of the legs, but it also acts as a cause of the development of trophic disorders, in which the nutrition of the lower extremities is subject to violation in particular. Trophic disorders can manifest themselves in hair loss and skin changes (thinning, pallor). Nails are prone to deformation, become brittle. In severe cases, atherosclerosis of the legs is accompanied not only by muscle atrophy, but also by the formation of trophic ulcers in combination with gangrene.

Arterial insufficiency of the legs manifests itself in accordance with the disorders that determine its main four stages.

• I stage . In this case, pain in the legs appears only in combination with significant physical exertion (for example, it can be walking for long distances (from one kilometer or more)).
• II stage . In this case, the limiting distance for the occurrence of pain is reduced, amounting to no more than 200 meters, after overcoming which, accordingly, the pain appears.
• III stage . Here, pain already occurs when walking within a distance of no more than 25 meters, or even at rest.
• IV stage . At this stage, trophic ulcers form in patients, gangrene of the lower extremities develops.

As another sign corresponding to the manifestations of atherosclerosis, the disappearance of the pulse, noted in the region of the arteries of the lower extremities (this may be the region on the back of the inner ankle, the region of the popliteal fossa, or the region of the thigh), is considered.

Thrombosis iliac arteries and the final part of the abdominal aorta provokes the development of Leriche's syndrome.

Leriche's syndrome is accompanied by a violation of blood circulation, relevant for the arteries of the lower extremities, as well as for organs concentrated in the pelvic area. Quite often, this syndrome develops against the background of atherosclerosis of the aorta. The manifestations of this pathology are similar to those that occur with atherosclerosis of the vessels of the legs.

In addition, impotence may develop, which, as you know, is relevant for men. Obliterating atherosclerosis of the vessels of the lower extremities can act as a serious kind of trophic disorders that directly affect the limbs (legs), which can also lead to the development of gangrene, and, ultimately, to the loss of one of them. Accordingly, any warning sign can serve as a reason for contacting a specialist.

Atherosclerosis of the coronary arteries of the heart: symptoms

This form of the disease acts as the main cause of the development of coronary heart disease in patients, which, in turn, develops against the background of impaired blood supply to the heart muscle. Myocardial infarction and angina pectoris are pathologies that directly depend on the degree of development of atherosclerosis that affects the arteries of the heart. Thus, with partial blockage, coronary disease develops (of varying degrees of severity of its own manifestation), and with complete blockage, myocardial infarction develops.

Focusing on the features of the pathology of interest to us, which is atherosclerosis of the coronary arteries of the heart, we highlight the features of the blood supply to the heart. It is provided in particular by two coronary arteries that follow from the aorta. With any violation that occurs during the circulation of blood through the coronary (coronary) arteries, the work of the heart muscle is disrupted, respectively. This, in turn, can lead to a heart attack.

Most often, blood circulation is disturbed against the background of atherosclerosis of the coronary arteries. In this case, this pathology is accompanied by the process of formation of dense plaques, due to which the deformation and destruction of the artery wall gradually occurs while its lumen narrows (a typical picture of the course of atherosclerosis). Symptoms of atherosclerosis of the coronary arteries correspond to those symptoms that appear in coronary artery disease, but the main cause in any case is precisely atherosclerosis.

The main manifestations of symptoms, respectively, in this case are the development of angina pectoris and coronary artery disease, cardiosclerosis and myocardial infarction act as complications of atherosclerosis of the heart vessels. An attack of angina, manifested in the form of atherosclerosis under consideration, is characterized by the following manifestations of symptoms:

• the appearance of burning, pressing pain in the chest; the spread of such pain to the left shoulder and to the back; occurrence - when it occurs stressful situations or during physical activity;
• shortness of breath (there is a feeling of lack of air, it is usually accompanied by the above pain attack; in some cases, it becomes necessary to take a sitting position, because the patient simply begins to suffocate while lying down);
• as possible option supplementing the picture of an attack is considered the appearance of symptoms such as headache, nausea, vomiting and dizziness.

Treatment of an angina attack is provided by taking nitroglycerin to patients, moreover, this drug is the main one in considering emergency relief of an attack.

With a complication in the form myocardial infarction patients develop intense pain, reminiscent of those that occur with angina pectoris. The difference is that the use of nitroglycerin does not determine the corresponding effect. As complementary manifestations of symptoms, severe shortness of breath is noted, the patient may lose consciousness. The manifestation of heart failure is characterized by its own sharpness.

If a complication such as cardiosclerosis, then heart failure with it manifests itself in a gradual manner, which is accompanied by a decrease in physical activity in combination with shortness of breath and the occurrence of swelling.

Definition specific signs corresponding to atherosclerosis of the coronary arteries can only be produced using special diagnostic techniques.

Atherosclerosis of mesenteric vessels: symptoms

This form of atherosclerosis manifests itself predominantly from the side of the upper abdomen. The time of manifestation of symptoms, which, first of all, is the appearance of pain, mainly occurs in the late hours, in particular after dinner. The duration of the manifestation of pain can be from several minutes to up to an hour. As concomitant manifestations of symptoms, bloating and belching may also be noted, and constipation may occur. Pain in atherosclerosis, when compared with pain associated with peptic ulcer, is not so long in manifestation.

The main symptoms associated with atherosclerosis in this form include the following manifestations:

• bloating;
• moderate manifestation of pain, determined by probing the abdomen;
• slight muscle tension in the anterior region abdominal wall;
• weakening of peristalsis or its complete absence.

The listed manifestations are defined as such a condition as "angina pectoris". It develops due to a discrepancy between the volume of blood required to provide blood supply to the organs of the digestive system and the actual volume, which, as can be understood, is insufficient for this.

As one of the complications of this form of atherosclerosis, thrombosis that develops in the mesenteric vessels can be noted. As a rule, it appears suddenly, accompanied by the following concomitant symptoms:

• constant pain of a wandering or diffuse nature that occurs in the abdomen;
• pain in the area of ​​​​the navel;
• nausea, repeated vomiting (with an admixture of bile; blood may also be present, which is noted in this case in the feces);
• constipation, flatulence (gas).

Often, thrombosis of the mesenteric vessels ends with the development of intestinal gangrene, which, in turn, is accompanied by severe symptoms of peritonitis.

Atherosclerosis of the renal arteries: symptoms

This form of atherosclerosis causes the development of a persistent form of ischemia, which, in turn, acts as a factor provoking the development of a consistently high form of arterial hypertension.

Some cases of atherosclerosis renal arteries accompanied by an absence of symptoms. Meanwhile, more often the picture of the disease manifests itself in the form of the development of atherosclerotic plaques with simultaneous narrowing of the lumen of the renal artery, against which a secondary form of arterial hypertension develops.

If only one of the renal arteries is affected, we can talk about the slow progression of this disease; in this case, high blood pressure becomes the foremost manifestation of symptoms. If the spread of the process affects both arteries at once, then this, in turn, causes the development of the disease according to a type in which arterial hypertension is malignant, characterized by rapid progression and a serious deterioration in the general condition of the patient.

Associated symptoms may include abdominal pain and pain in the lumbar region. The duration of pain sensations manifests itself in different ways, in some cases being about several hours, in others - about several days. Nausea and vomiting may also occur.

Diagnosis

The primary diagnosis of atherosclerosis is carried out by a therapist as part of a standard annual examination of the patient in this area. To do this, pressure is measured, risk factors that contribute to the development of atherosclerosis are identified, and body mass index is measured.

As a clarifying measure, the following research methods can be applied:

• ECG (echocardiography) in combination with ultrasound of the aorta and heart, as well as with special stress tests;
• Invasive research methods (coronary angiography, angiography, ultrasound intravascular examination);
• Duplex scanning, triplex scanning (blood flow is subject to examination by means of ultrasound imaging of blood vessels);
• MRI (magnetic resonance imaging), through which visualization of atherosclerotic plaques and arterial walls is performed.

Treatment

Treatment of atherosclerosis is based on a number of the following principles:

• impact on infectious agents;
• implementation of measures replacement therapy(relevant for women during menopause);
• increased excretion of cholesterol and its metabolites from the body;
• limiting the intake of cholesterol in the body, reducing the synthesis of cholesterol by cells.

Against this background, the lifestyle is subject to adjustments, a diet is additionally prescribed, in which, as you can understand, products containing cholesterol are subject to the maximum exclusion.

As for drug treatment, it is based on taking the following types of drugs:

• nicotinic acid in combination with its derivatives (providing the possibility of lowering cholesterol and triglycerides in the blood, as well as increasing the content of lipoproteins with high density due to them);
• fibrates (drugs of this group provide a decrease in the synthesis of their own fats by the body);
• statins (provide the ability to reduce cholesterol in the most effective way by influencing the processes of their production by the body itself);
• sequestrants (provide binding and excretion of bile acids from the intestines while reducing cholesterol and fats in cells).

Atherosclerosis may require, in some cases, surgical treatment, which is important in case of a serious threat or the development of an acute form of blockage by a thrombus or artery plaque. An endarterectomy may be performed for this. open operation on the artery) or endovascular surgery (dilatation of the artery, installation of a stent in the area of ​​narrowing, due to which an obstacle is provided for subsequent blockage). A pronounced form of atherosclerosis with damage to the vessels of the heart, against which a myocardial infarction may develop, requires coronary artery bypass grafting.

Yandex.Zen

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