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Changing Lifestyles, Changing Habits: Preventing or Reversing Atherosclerosis

separator Atherosclerosis is the main cause of heart disease in the United States. What causes it? How can you avoid it? What should you do if you already have it?

The heart gets its supply of oxygen and nutrients from the blood. The coronary arteries carry the blood to the heart. If the arteries become clogged, blood flow is restricted, or blocked. Eventually the blockage is likely to cause heart pain, or angina. If the blood supply is cut off completely, the result is a heart attack. During a heart attack, the areas of the heart muscle that don't receive oxygen begin to die. Often, the heart muscle suffers permanent damage.

This arterial blocking that causes angina and heart attacks is called atherosclerosis.

What Causes the Clogging?
The gradual buildup of fatty substances (cholesterol and triglycerides) in blood vessels is the cause of atherosclerosis. The walls of the arteries become too thick, narrowing the passageways where blood flows to the heart. The condition is often called "hardening of the arteries," because the cholesterol and triglycerides that stick to the arterial wall can cause plaque to form. In most cases, these areas of plaque become "calcified" and hard.

If there is no calcification, the plaque remains soft. Soft plaques often have an oily center, which is called the fatty core. This core can break off and enter the flow of blood, causing a block. This is a highly common cause of heart attacks.

What are the Risk Factors?
You're more likely to develop atherosclerosis if you have the following risk factors:
  • High levels of LDL cholesterol and low levels of HDL cholesterol in the blood
  • High levels of triglycerides (blood fats)
  • High levels of homocysteine, an amino acid that can damage the walls of the arteries
  • High blood pressure
  • Smoking
  • Diabetes
  • Obesity
  • Unmanaged stresses of everyday life
  • Inactive lifestyle
About five percent of the people have a genetic reason for high cholesterol and other fat levels in the blood. In other words, 95 percent of the high blood fat problems are due to lifestyle factors.

What do you Need to Change?
There are so many things you can do to lower your risk of atherosclerosis, and to improve the condition if you already have it.

Do you smoke? Smoking is a leading risk factor for heart disease. If you've tried to quit on your own but haven't succeeded, get help. Talk with your doctor for advice. Studies have shown that people who get help from their doctor have a higher success rate than people who try to quit on their own.

Do you have diabetes? If so, are you doing everything you can to control your blood sugar? If you haven't talked with your doctor and other members of your health care team lately, now is the time to make an appointment. Make sure your diabetes care plan is up-to-date, because your diabetes needs change over time.

What about high blood pressure? Do you get regular exercise? If your doctor has prescribed medication, do you take it regularly? Do you eat well? All of these things can help control your blood pressure.

Do you get exercise almost every day? A sedentary lifestyle isn't helping you decrease your risk of heart disease at all. Finding a way to fit about 30 minutes of exercise into every day can be a challenge, but people generally figure it out if they make it a priority. The truth is you might have to eliminate some activities in favor of adding exercise.

Do you find time to enjoy life? Everyday life itself is stressful, even when things are going well. Make sure you find time to relax and enjoy time with your friends and family. Develop interests beyond work. The more meaningful and enjoyable life is for you, the better you're managing your stress levels.

What about food? Do you go to all-you-can-eat buffets and eat all you can? Do you eat in fast-food restaurants? Eat over-stuffed deli sandwiches? Pile on the pasta? Even a single meal that's high in fat can cause your arteries constrict, or spasm. The more good changes you make to your diet, the better your chances of keeping your arteries clear and reducing the risk of a heart attack.

If you want to identify your unhealthy eating habits, sit down with a nutritionist and talk about what kinds of foods you need to stop eating, and what you need to replace those foods with. It's hard to learn this all at once if you've been eating a certain way all your life.

Read the article about food labels in this issue of the magazine to help you make healthy food choices.

The American Heart Association; L. Sauvage. You Can Beat Heart Disease. Better Life Press, Seattle, 1998; F. Pashkow and C. Libov. The Women's Heart Book. Hyperion, New York, New York, 10023, 2001.
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