Atherosclerosis, the silent enemy

| In Articles | 16th March 2020

Atherosclerosis is a disease characterised by the deposition of cholesterol-rich granules in monocytes/macrophages in the arterial wall.

Atherosclerosis - heart disease affecting the artery

It can happen inside any artery of the human body.

Macrophages are large white blood cells found in body tissues and monocytes are their equivalent in blood. They are best known for their phagocytic role (the ability to engulf and destroy pathogens) but also for their function in tissue repair and metabolism.

Risk factors for atherosclerosis

  • diabetes;
  • hypertension (BP higher than 140/90);
  • smoking;
  • dyslipidemia (total cholesterol higher than 200mg/dl, LDL cholesterol higher than 120md/dl), HDL lower than 60mg/dl);
  • age (men older than 45 and women older than 55);
  • obesity;
  • waist circumference more than 102cm for men and more than 84cm for women;
  • genetics;
  • sedentary lifestyle;

Atherosclerosis develops progressively and the end result is atherosclerotic plaque.

This happens through the accumulation of cholesterol-rich lipids and the inflammatory response triggered by this process.

Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. Over time, plaque hardens and causes vascular occlusion which means that the normal blood flow is restricted.

Plaque rupture will lead to the formation of blood clots which can travel to any part of the body such as the heart, brain, lungs etc. causing heart attack, stroke, pulmonary embolism (blockage of a blood vessel in the lung), sudden cardiac death and many other complications.

Atherosclerosis of the coronary vessels will cause ischemic heart disease.

The list of diseases caused by Atherosclerosis includes:

  • stable or unstable angina;
  • miocardial infarction or sudden cardiac death.


Angina is a disorder manifested by regular attacks of severe pain in the chest often also radiating to the shoulders, arms and neck.

  • Stable angina most often occurs with activity or emotional stress.
  • Unstable angina (also called acute coronary syndrome) causes unexpected chest pain even at rest.

Miocardial infarction or heart attack

Miocardial infarction or heart attack is a serious condition where the blood flow to part of the heart is suddenly interrupted.

Clinical signs include chest pain, shortness of breath, dizziness and sweating.

Angina and miocardial infarction may cause similar symptoms therefore chest pain should be treated as a medical emergency.

A short anatomy recap: coronary arteries of the heart are the first branches of the aorta and include the left main and right coronary arteries.

The left main coronary artery divides into: the left anterior descending artery and the circumflex artery.

The right coronary artery divides into: right posterior descending artery and the acute marginal artery.

How to recover from Atherosclerosis

Atherosclerosis can be reversed during the early stages through keeping body cholesterol within normal levels.

This can be achieved by eating healthy food, regular exercise, smoking cessation, losing extra body weight and managing stress levels.

Advanced atherosclerotic lesions are irreversible and require long term medical treatment or surgery.