Why are my arteries clogging up?
Atherosclerosis, defined as the hardening of the arteries caused by plaque formation, has long been known as the cause of cardiovascular diseases such as heart attack and stroke.
Arteries are tube like vessels that carry nutrient rich blood from the heart to all the cells of our body including cells of the heart and the brain. The largest artery called “aorta” leaves the heart and then subsequently divides into smaller and smaller vessels to reach each cell of the body.
Plaque formation in these arteries leads to decrease in size of the lumen of these vessels. It becomes an issue when a piece of this plaque breaks off, is carried off by the blood, and lodges itself into a smaller vessel. This can lead to complete blockage of the vessel.
What follows is that the cells which normally get their nutrients & oxygen from the blood can no longer get it because the small vessel gets fully blocked by this piece of plaque. This leads to cell starvation and death.
If this blockage happens in the vessel supplying blood to the heart, it leads to a “heart attack”. If the blockage happens in the vessel supplying the brain, it leads to a stroke. Two fatal consequences of “atherosclerosis”
The question then is , “Why is this plaque forming in the arteries” in the first place?
For years the understanding was that cholesterol was the sole cause of this plaque formation. Too much cholesterol in our diets and or too much being made by our body was being deposited in these plaques causing the arteries to get blocked. Drugs that targeted the “bad cholesterol” were successful at reducing the risk of heart disease, so this theory made sense.
Researchers then began to realize that these “statin” drugs being used to treat high cholesterol levels in the body had anti-inflammatory properties too.
Perhaps there was more than just cholesterol reduction that was decreasing the heart disease risk.
New research began to show that cholesterol is just a piece of the puzzle and that something else is happening in the arteries that leads to the formation of these plaques.
This new understanding led researchers to realize that the root cause of atherosclerosis is in fact “Chronic Inflammation” caused by damage to these blood vessels.
The CANTOS trial done in 2017 and published in the New England Journal of Medicine finally provided the much-needed proof for this inflammatory hypothesis of plaque formation.
https://www.nejm.org/doi/full/10.1056/nejmoa1707914
The process of Atherosclerosis begins with injury to the lining of the blood vessel. Inflammation process is initiated by the body to heal this injury.
Inflammation is a process that the body uses to heal us from infections and injury. It is a good thing if it is short term but if the injury is persistent, the inflammation becomes chronic and long term, and this is when it becomes dangerous.
Cholesterol forms part of this plaque along with many other cells of our immune system, but cholesterol is not the sole reason for the formation of the plaque.
Chronic inflammation plays a huge role in the creation of these plaques.
Hence if we want to modify our cardiovascular risks then we need to work on decreasing chronic inflammation in our body.
This is empowering news!
This new understanding opens up opportunities not only for prevention but treatment using lifestyle modifications. We know that many lifestyle changes can lead to reduction in chronic inflammation.
It includes such things as
- Consuming an anti-inflammatory plant based diet.
- Managing blood sugar levels
- Reducing chronic stress
- Balancing gut bacteria
- Getting a good night sleep
- Maintaining a positive mindset & heartset
All these lifestyle changes can influence the level of inflammation in our body.
If chronic inflammation is behind the formation of plaques in the arteries, then it makes sense that when you reduce inflammation in the body through lifestyle changes, you would reduce the plaque buildup in the arteries.
This new understanding of “Atherosclerosis” is empowering and gives us hope that we are not doomed by our genes.