Essentially atherosclerosis is hardening of the arteries.
Our arteries are meant to be clear but in time we can develop lesions, otherwise known as plaques. These plaques can narrow and stiffen the arteries and may eventually lead to total obstruction or closure of the artery. When this occurs it can cause a heart attack or stroke. In fact most forms of heart disease are caused by atherosclerosis so it is important to understand it and also understand how we can avoid it.
But how and why do we get atherosclerosis?
The process of atherosclerosis begins in childhood with streaks appearing in the coronary arteries, the ones closest to your heart. In a sense this is a ‘normal’ function of the body. It is happening at a more rapid rate these days and occuring in younger people too, and this is largely due to our modern pro-inflammatory lifestyle. I wrote about what causes heart disease over here and I’d recommend you read that article as well.
Essentially what causes the whole process to occur is inflammation. Atherosclerosis has now been well established as an inflammatory disease. Why do we get inflammation? Largely due to our unhealthy diet and liifestyle. Read more about inflammation here and here.
The 4 Stages of Atherosclerosis
Stage 1. Epithelial damage
The epithelial cells are the cells that make up the lining of all the artery walls. This lining is called the endothelium. So the endothlieum can be damaged and injured. This occurs mostly due to inflammation that causes injury to the artery lining. Other factors that cause injury include hypertension, diabetes, and smoking.
Stage 2 – Fatty streak development (otherwise known as Athroma)
Once the injury occurs the epithelial cells secrete adhesion molecules that attract various immune cells and LDL cholesterol to the site of injury. The immune cells and LDL pass through the endothelium membrane and lodge under the membrane, causing a fatty streak.
Stage 3 – Plaque growth and instability
With ongoing inflammation the cells that have formed the fatty streak start to attract more immune cells and vascular smooth muscle cells to the area. In this stage cells are very active and they can migrate and proliferate, meaning they can move around and increase in number. The vascular smooth muscle cells form a fibrous cap (a connective tissue) on top of the cells and it becomes a plaque. For various reasons, mostly due to inflammation the plaque can be unstable and so stage 4 starts to occur.
Stage 4 – Plaque rupture, clot/thrombis development, and obstruction of the artery
If the plaque ruptures the material that gets deposited inside the plaque leaks out of the plaque back into the bloodstream. Once this occurs blood platelets are attracted to the leaking plaque. Blood platelets are the cells that come and stop bleeding and form a clot when we get a wound but during atherosclerosis they think there is something wrong and go in to stop the plaque from leaking. This creates a thrombus or clot. Problem is that sometimes the platelets keep attracting more platelets and the thrombus/or clot can completely block the artery and cause an immediate heart attack or stroke.
Essentially that is the process that can occur from cell damage through to heart attack. BUT it doesn’t necessarily happen.
Can You Reverse Atherosclerosis?
The plaque formation itself is not neccesarily the issue. The issue is when the plaque ruptures and interestingly some studies have shown that the arterial wall can actually remodel itself and widen in response to a plaque so that it maintains diameter and blood flow (I just love the amazing capacity of the body).
Inflammation is the cause of atherosclerosis at every level during development and rupture as well. The role of inflammation is what is integral to the structure of the fibrous cap. Thin fibrous caps result in plaque rupture and the presence of inflammation interrupts cap development because essentially it is the vascular smooth muscle cells forming a collagen matrix over the plaque. I imagine this process is kind of like the skin healing a wound. So if the wound stays healed then all well and good. The plaque may always be there but won’t necessarily cause a problem. When there is inflammation, the inflammatory process interferes with fibrous cap development and degrades the cap as well and so this leads to plaque ruupture and the possibility of subsequent heart attack or stroke.
So can you reverse it? Well not the plaque development BUT you can stop it in it’s tracks!
A healthy diet and lifestyle can reduce inflammation so you stop the advanced development of plaques and prevent rupture from occuring.
Yes that’s right, our food is our medicine and eating well can literally save your life.
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For now take care
Nutritionist & Health Counselor