Atherosclerosis

Atherosclerosis is a disease that affects the arteries and is characterised by the formation of fat plaques, called atheromas, on the walls of these vessels. These plaques accumulate mainly in areas with higher "turbulence" in blood flow, such as arterial bifurcations, and cause a progressive narrowing of the arteries, hindering blood flow. This process begins silently from a young age and can develop slowly, which is why it is important to adopt preventive measures early on. Atherosclerosis is responsible for various serious diseases such as high blood pressure, coronary artery disease, aortic aneurysms, and peripheral arterial disease, and it is one of the leading causes of death in Portugal.

In many cases, atherosclerosis presents no symptoms until blood supply to an organ is reduced. When this happens, the signs vary depending on the affected organ. In the case of cerebrovascular disease, transient ischemic attacks may occur, with symptoms that disappear in less than 24 hours, or strokes. When it affects the heart, atherosclerosis can cause chest angina, myocardial infarction, or acute coronary syndrome. In peripheral arterial disease, which affects the legs, the person may feel pain while walking, known as intermittent claudication, or even pain at rest, and the skin on the feet may become cold, pale, or bluish. In more advanced cases, erectile dysfunction, chronic kidney failure, and aneurysms may occur. Atherosclerosis can also affect abdominal circulation, causing abdominal pain after meals, often associated with bloating, vomiting, or diarrhoea, when there is obstruction of the intestinal arteries.

The main risk factors for atherosclerosis include elevated blood cholesterol levels, especially LDL, or "bad cholesterol," high blood pressure, diabetes, a family history of cardiovascular diseases, smoking, obesity, physical inactivity, and advanced age. Diagnosis begins with clinical history and the assessment of signs and symptoms, with the physical examination potentially showing fat deposits on the eyelids or tendons, changes in arterial pulses, or the presence of carotid bruits. To confirm the diagnosis and assess the severity of the disease, supplementary tests such as blood tests, electrocardiogram, echocardiogram, and ultrasound of the arteries may be carried out.

Although there is no cure for atherosclerosis, treatment aims to control the risk factors and prevent disease progression. Lifestyle changes, such as a healthy diet, regular physical exercise, quitting smoking, and controlling blood pressure and diabetes, are essential. Furthermore, when complications such as coronary artery disease or arterial insufficiency are already present, medication is required to control its progression. In some cases, when the disease is very advanced, surgery may be necessary to unblock the arteries or treat aneurysms.