What I Learned Series 4: Atherosclerosis

What I Learned Series 4: Atherosclerosis

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What is Atherosclerosis?

Atherosclerosis – A chronic condition in which:

  1. Artery walls thicken and become less elastic
  2. Artery diameters decrease because of the build up of plaque on the inner walls

Atherosclerosis happens in large blood vessels – Arteries particularly near to the heart.

The flexibility of arteries reduce risk of atherosclerosis. The first 2 layers – endothelial cells which allow arteries to expand and the smooth muscle layer which has the ability to expand or constrict.

  • Reducing the diameter of the blood vessels have a significant effect in increasing the blood pressure.
  • High blood pressure is a risk factor for atherogenesis

Risk Factors

Susceptibility to atherosclerosis depends upon a number of factors, including:

1.Diet

2.Lack of exercise

3.Obesity

4.Smoking

5.Diabetes

6.Genetic factors

7.High cholesterol

Trans fatty acids and diabetes are very well related to atherosclerosis which may damage endothelial cells and can be a trigger for atherosclerosis. Glucose can attach to the cells and an accumulation of glucose may cause damage to activate the immune system to cause an inflammation response. 

What I Learned Series 4: Atherosclerosis

*That’s why grass-fed beef are usually leaner rather than grain-fed beef because as we know the consumption of plants can reduce the build-up of fat and plaque around the muscles. https://www.fix.com/blog/grass-fed-beef/

How Does Atherosclerosis Develop?

1. An irritant such as smoking, hyperlipidaemia, or hypertension irritates the Endothelial cells/Tunica intima (inner layer) causing

2. Endothelial dysfunction which causes the breakdown of endothelial cells.
3. LDL then breaches into the tunica intima layer
4. Macrophages breach into the tunica intima layer to devour the LDL then die to become Foam Cells
5. The molecules of LDL merge into a “lake of fat” inside the tunica intima layer
6. Smooth muscle cells start migrating into the tunica intima layer and make a fibrous cap made of collagen and elastin
7. Smooth muscle cells start to calcify the fibrous cap
 
KEY CHANGES
1. This causes a small blood vessel radius (Increasing resistance)
2. The calcified fibrous cap decreases compliance (decreasing flexibility)
 
Life-saving videos below!

https://www.khanacademy.org/science/health-and-medicine/circulatory-system-diseases/blood-vessel-diseases/v/atherosclerosis-part-1

https://www.khanacademy.org/science/health-and-medicine/circulatory-system-diseases/blood-vessel-diseases/v/atherosclerosis-part-2

It is feasible to reverse any damage in the blood vessel through diet and physical activity but once the cap is formed and calcified (check video) it is possible to undertake an operation to change the structure of the blood vessel.

Trans fatty acids have been shown to increase the synthesis of LDL

What I Learned Series 4: Atherosclerosis

https://www.verywellhealth.com/what-is-atherosclerosis-1745908

What Controls the Dilation and Contraction of Blood Vessels?

Nitric oxide production in the endothelial cells is the key vasodilator in our body to relax smooth muscle cells to increase the size of blood vessels.

Endothelin-1 is a vasoconstrictor to help reduce the size of the blood vessels and increase blood pressure

  • Hypertensive individuals have higher levels of endothelin 1 and lower levels of NO.
  • An overproduction of endothelin 1 can trigger mitochondrial dysfunction and an overproduction of free radicals can shorten the half life of NO

Both are vital for homeostasis. Endothelin – 1 is released during eating to send blood for digestion and nitric oxide is used to for exercise for example

L-arginine

L-arginine is a non-essential amino acid which is not produced by the body so it is important to get L-arginine through the diet.

Check out:  What I Learned Series! 2: How to Get Patients to Listen to You

L-Arginine creates nitric oxide through the enzyme nitric oxide synthases

What I Learned Series 4: Atherosclerosis

https://www.mrsupplement.com.au/nitrate-supplements

Studies are not complete yet but it has been shown that antibacterial mouthwash may reduce number of bacteria that convert nitrate to nitrate which can leave BP increased.

Nitric oxide is a free radical so very high doses, nitric oxide may be toxic. Parkinson’s and Alzheimer’s is due to an overproduction of nitric oxide.

Sources of Nitric oxide: Rocket (one of the best sources), green leafy vegetables, and beetroot juice. Dietary sources are nitrate are a good way to reduce blood pressure.

DOES ATHEROSCLEROSIS AFFECT VEINS?

skinny fat

Blood pressure is measured in the arteries not the veins because the veins do not have much elasticity and the muscle layer is much thinner compared to arteries.

Deep Vein Thrombosis is the formation of a thrombus in the veins due to the accumulation of blood in the small blood vessels. Heparin treats DVT and happens to those resting for a long period of time like those in hospitals.

A thrombi in the legs can travel through the heart to the lungs to cause pulmonary embolism which is a life-threatening situation. Blood going out of the heart goes to the lungs first.

TREATMENT

What I Learned Series 4: Atherosclerosis

https://www.researchgate.net/publication/296335603_Angiotensin_converting_enzyme_inhibitors_remain_the_first_treatment_of_choice/figures?lo=1

There are a number of treatments which are of benefit in controlling pre-existing and developing atherosclerosis.  These include:

  1. The statins
  2. ACE inhibitors

1. Statins are particularly useful in treating cardiovascular diseases. These drugs operate by inhibiting the enzyme HMG CoA reductase. This leads to a reduction in cholesterol production.

Side effects of statins taken chronically: Can reduce insulin sensitivity and lead to accumulation of fatty acids in the liver.

2. ACE inhibitors have been found to be very successful in treating hypertension.

Studies have shown that activity in the renin-angiotensin system can aggravate the consequences of atherosclerosis. Treatment with ACE inhibitors can improve blood vessel tone. ACE inhibitors may help reduce the impact of atherosclerotic activity

 

The best way of reducing the risk of developing atherosclerosis remains regular exercise combined with a sensible diet.

Jonathan Sumner
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Jonathan Sumner

Who am I? Trainee Diet Police? Nope!

I want to improve peoples’ relationship with food; To fall in love with meal times rather than them focusing on numbers - For people to be healthy, be comfortable in their own skin, and to love themselves. 🙂
Jonathan Sumner
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