What is atheroma?
Patches of atheroma are like small fatty lumps that develop within the inside lining of blood vessels (arteries).
Over months or years, patches of atheroma can become larger and thicker. So in time, a patch of atheroma can make an artery narrower. This can reduce the blood flow through the artery. For example, narrowing of the heart (coronary) arteries with atheroma is the cause of angina.
Sometimes, a blood clot (thrombosis) forms over a patch of atheroma and completely blocks the blood flow. Depending on the artery affected, this can cause a heart attack, a stroke, or other serious problems.
Clinical Editor's note
December 2017 - Dr Hayley Willacy recently read an interesting paper on the cause of atheroma - see Further reading and references below. It states that despite popular belief among doctors and the public, the model of dietary saturated fat clogging a pipe is just plain wrong. It is time to shift the public health message in the prevention and treatment of coronary artery disease away from measuring levels of lipids in the blood and reducing dietary saturated fat. Coronary artery disease is a chronic inflammatory disease and it can be reduced effectively by walking 22 min a day and eating real food.
What are the diseases caused by atheroma?
Atheroma is the root cause of a number of cardiovascular diseases. Cardiovascular diseases are diseases of the heart (cardiac muscle) or blood vessels. However, in practice, when doctors use the term cardiovascular disease they usually mean diseases of the heart or blood vessels that are caused by atheroma.
In summary, cardiovascular diseases caused by atheroma include:
- Heart disease: angina or a heart attack.
- Cerebrovascular disease: stroke or a transient ischaemic attack (TIA).
- Peripheral arterial disease.
- Vascular dementia.
In the UK, cardiovascular diseases are a major cause of poor health and the biggest cause of death.
Vascular dementia is the second most common type of dementia after Alzheimer's disease.
Dementia is a set of problems that include memory loss and difficulties with thinking, problem-solving or language. Vascular means it is caused by problems with the blood supply.
In vascular dementia, the dementia symptoms occur when the brain is damaged because atheroma has reduced the supply of blood to the brain. The section of brain supplied by the atheroma-blocked blood vessel is damaged, or dies. This is like having a lot of little strokes (or 'infarcts') in the thinking part of the brain. After each infarct, some more brain tissue is damaged and a person's mental ability gradually worsens.
Further reading and references
2016 European Guidelines on cardiovascular disease prevention in clinical practice; European Society of Cardiology (2016)
2016 ESC/EAS Guidelines for the Management of Dyslipidaemias; European Society of Cardiology (2016)
de Souza RJ, Mente A, Maroleanu A, et al; Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies. BMJ. 2015 Aug 11351:h3978. doi: 10.1136/bmj.h3978.
Linton MF, Yancey PG, Davies SS, et al; The Role of Lipids and Lipoproteins in Atherosclerosis
Malhotra A, Redberg RF, Meier P; Saturated fat does not clog the arteries: coronary heart disease is a chronic inflammatory condition, the risk of which can be effectively reduced from healthy lifestyle interventions. Br J Sports Med. 2017 Aug51(15):1111-1112. doi: 10.1136/bjsports-2016-097285. Epub 2017 Apr 25.
Crandall JP, Mather K, Rajpathak SN, et al; Statin use and risk of developing diabetes: results from the Diabetes Prevention Program. BMJ Open Diabetes Res Care. 2017 Oct 105(1):e000438. doi: 10.1136/bmjdrc-2017-000438. eCollection 2017.
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