Arteriosclerotic cardiovascular disease

Arteriosclerotic Cardiovascular Disease
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Synonyms	Atherosclerotic cardiovascular disease (ASCVD)
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Arteriosclerotic cardiovascular disease (ASCVD) is a broad term encompassing any cardiovascular disease that results from the thickening and hardening of the arteries due to the buildup of atherosclerotic plaques. This condition is a major cause of morbidity and mortality worldwide, primarily affecting the heart, brain, and peripheral arteries.

Causes

ASCVD is primarily caused by atherosclerosis, a process in which lipids, cholesterol, calcium, and other substances build up in the arterial walls forming plaques. These plaques can restrict blood flow or rupture, leading to serious cardiovascular events such as myocardial infarction (heart attack) or stroke. Risk factors include smoking, high blood pressure, diabetes mellitus, obesity, poor diet, and lack of physical activity.

Pathophysiology

In arteriosclerosis, the blood vessels become stiff and thickened, often due to the deposition of calcium in the vessel walls. In atherosclerosis, which is a type of arteriosclerosis, plaques composed of fats, cholesterol, and other substances accumulate on the arterial walls. These changes can reduce the elasticity of the arteries and narrow the passage through which blood flows, increasing the risk of thrombosis and ischemia.

Symptoms and Signs

The symptoms of ASCVD depend on the arteries affected. If the coronary arteries are involved, it may lead to symptoms of angina or heart attacks. Cerebral arteries involvement can lead to transient ischemic attacks or strokes. Peripheral arterial disease can cause leg pain, particularly when walking.

Diagnosis

Diagnosis of ASCVD involves a combination of medical history, physical examinations, and diagnostic tests. These may include blood tests to measure lipids and glucose levels, electrocardiogram (ECG), echocardiogram, and imaging studies such as computed tomography (CT) scan or magnetic resonance imaging (MRI) of the arteries.

Treatment

Treatment of ASCVD focuses on reducing the risk factors and managing symptoms. This includes lifestyle changes such as diet, exercise, and smoking cessation. Medications may include statins for cholesterol management, antihypertensive drugs for blood pressure control, and antiplatelet drugs like aspirin to prevent blood clots. In severe cases, surgical interventions such as angioplasty or coronary artery bypass grafting (CABG) may be necessary.

Prevention

Prevention of ASCVD involves managing risk factors through lifestyle changes and, in some cases, medications. Regular physical activity, a healthy diet low in saturated fats and high in fruits and vegetables, maintaining a healthy weight, and avoiding tobacco use are all crucial steps in preventing the development of arteriosclerotic disease.

Epidemiology

ASCVD remains a leading cause of death globally, with millions of people affected. The prevalence of ASCVD increases with age and varies by geography and ethnicity due to differences in lifestyle, diet, and access to healthcare.