Definition

Hardening of arteries brought by lesions known as atherosclerotic plaques, or atheromas.

  • Generally, atheromas are nodules containing gruel, fatty, wax-like substance
    • Composed of a soft, necrotic, lipid core (mainly cholesterol and cholesterol esters)
    • Covered by a fibrous cap
  • As the plaques enlarge, they obstruct the vessel (stenosis) and change the flow hemodynamics
  • The change in flow increases the shear stress, which often causes the rupture of the plaque
    • Plaque fate is discussed in detail below
  • Atherosclerosis common occurs in the coronary arteries and is responsible for the majority of myocardial infarctions

Risk factors

Atherosclerosis is a complex, multifactorial chronic condition with many known risk factors. We can classify them into modifiable (factors under our influence) and non-modifiable factors:

  • Modifiable
    • Hyperlipidemia and hypercholesterolemia
      • Increased levels of LDL and decreased levels of HDL
        • LDL mobilizes lipids from the liver to the periphery ("bad cholesterol")
        • HDL mobilizes lipids from the periphery to the liver ("good cholesterol")
    • Hypertension
    • Cigarette smoking
    • Diabetes Mellitus
      • Associated with hypercholesterolemia
      • The cytological metabolic changes provide a favorable environment for the formation of atherosclerosis
    • Metabolic

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