By Liz Seegert
Approximately 75% of acute myocardial infarctions (heart attacks) occur from plaque rupture brought on by atherosclerosis. The highest incidence of plaque rupture happens in men over 45; in women, the incidence increases after age 50. This gender difference in atherosclerosis prevalence is thought to be due to the protective function of female sex hormones, which decline after menopause.
Atherosclerosis also is the leading cause of strokes. Prior to COVID-19, stroke from any cause represented the fifth leading cause of death and the major cause of serious long-term disability in adults in the United States. In 2018, one in every six deaths from cardiovascular disease was due to stroke, according to the CDC. More than 795,000 people in the United States suffer a stroke every year, and someone dies of a stroke every four minutes.
The CDC has these helpful stats and maps of stroke incidence in the U.S. by race and ethnicity.
What to know when reporting on atherosclerosis
- While the term atherosclerosis sometimes is used interchangeably with arteriosclerosis, they are not the same thing.
- Arteriosclerosis occurs when the blood vessels that carry oxygen and nutrients from the heart to the rest of the body become thick and stiff, sometimes restricting blood flow to organs and tissues. Healthy arteries are flexible and elastic, but over time, the walls in the arteries can harden, a condition commonly called hardening of the arteries.
- Atherosclerosis is the buildup of plaque — fats, cholesterol, fatty substances, cellular waste products, calcium and fibrin (a blood-clotting material) in and on the artery walls. It can cause narrowing of the arteries, blocking blood flow. The plaque can also rupture, leading to a blood clot. Atherosclerosis often is considered a heart problem but can affect arteries anywhere in the body. This can lead to coronary heart disease, angina; carotid artery disease, peripheral artery disease (PAD) or chronic kidney disease. Atherosclerosis can begin early in life as fatty streaks begin building up in an artery’s inner lining.
- The National Heart, Lung, and Blood Institute says certain habits or conditions increase risk for atherosclerosis, including:
- Unhealthy blood cholesterol levels. High LDL cholesterol (so-called “bad” cholesterol) and low HDL cholesterol (so-called “good” cholesterol).
- High blood pressure. Blood pressure is considered high if it stays at or above 140/90 mmHg over time. For those with diabetes or chronic kidney disease, high blood pressure is defined as 130/80 mmHg or higher.
- Smoking. Smoking damages and tightens blood vessels, raises cholesterol levels, and raises blood pressure. Smoking also doesn’t allow enough oxygen to reach the body’s tissues.
- Insulin resistance. This condition occurs if the body can’t use its insulin properly. Insulin is a hormone that helps move blood sugar into cells where it’s used as an energy source. Insulin resistance may lead to diabetes.
- Diabetes.
- Being overweight or obese.
- Lack of physical activity. Inactivity can worsen other risk factors for atherosclerosis, such as unhealthy blood cholesterol levels, high blood pressure, diabetes, and being overweight or obese.
- Unhealthy diet. Foods high in saturated and trans fats, cholesterol, sodium and sugar can worsen other atherosclerosis risk factors.
- Older age. The risk for atherosclerosis increases with age. Genetic or lifestyle factors cause plaque to build up in the arteries as people age. By the time someone is middle-aged or older, enough plaque has built up to cause signs or symptoms.
- Family history of early heart disease. The risk for atherosclerosis increases if a person’s father or a brother was diagnosed with heart disease before age 55 or if their mother or a sister was diagnosed with heart disease before age 65.
- Sleep apnea. If left untreated, it can raise the risk for high blood pressure, diabetes, heart attack or stroke.
- Stress. Research shows that the most commonly reported “trigger” for a heart attack is an emotionally upsetting event, especially one involving anger.
- Alcohol. Heavy drinking can damage the heart muscle and worsen other risk factors for atherosclerosis.
Although age and a family history of early heart disease are risk factors, it doesn’t mean that someone definitely will develop atherosclerosis. Controlling other risk factors and adopting a healthier lifestyle can often mitigate genetic influences and may prevent the condition, even in older adults. Atherosclerosis is treatable with statins, which can slow its progression and pull cholesterol out of artery-clogging plaque. Statins can also help stabilize these plaques and keep them from breaking open.
When lifestyle changes and medications aren’t keeping atherosclerosis under control — or if someone is in serious danger of having a heart attack — angioplasty may be required to open a blocked artery. Alternatively, coronary artery bypass surgery may be needed to carry blood around the obstruction.
Studies show that an increasing number of children and youth are at risk for atherosclerosis due to several causes, such as childhood obesity, which is on the rise.
