Plaque In Arteries: A Ticking Time Bomb For Stroke?

Strokes, sometimes called brain attacks, occur when blood flow to the brain is cut off. This can happen when there is a buildup of plaque in the arteries, a condition known as atherosclerosis. Atherosclerosis is a slow, complex disease that typically starts in childhood and progresses with age. It causes the arteries to thicken and harden, reducing blood flow and oxygen supply to the brain. This can lead to an ischemic stroke, which can cause permanent brain damage and body function impairment. In some cases, the plaque in the arteries can break, forming blood clots that block blood flow and cause a stroke.

Atherosclerosis and arteriosclerosis are two conditions that contribute to plaque buildup

Atherosclerosis and arteriosclerosis are two distinct conditions that contribute to plaque buildup in the arteries. Atherosclerosis is a specific type of arteriosclerosis, which is a group of conditions characterised by thickening and stiffening of the arteries. This hardening of the arteries can interrupt blood flow, leading to circulation problems and an increased risk of cardiovascular events.

Arteriosclerosis, the general term for the group of conditions, can be caused by factors such as ageing, scarring, calcium deposits, diabetes, and high blood pressure. However, atherosclerosis is a specific type of arteriosclerosis with distinct causes, symptoms, and treatments. Atherosclerosis is characterised by the buildup of plaque, a sticky substance composed of cholesterol, fat, blood cells, and other substances, along the inner lining of the arteries. This plaque thickens the artery walls, narrowing the blood vessels and further reducing blood flow.

Atherosclerosis typically affects large and medium-sized arteries and can develop slowly over time, sometimes starting in childhood. Risk factors for atherosclerosis include high blood cholesterol, unhealthy lifestyle habits, and genetic predisposition. The condition can lead to serious health complications, including heart disease, stroke, and vascular dementia.

Arteriosclerosis, on the other hand, refers specifically to the hardening of the arteries. While atherosclerosis is caused by plaque buildup, arteriosclerosis can occur without plaque formation. There are several types of arteriosclerosis, including nonatheromatous arteriosclerosis, Mönckeberg's arteriosclerosis, hyaline arteriolosclerosis, and hyperplastic arteriolosclerosis. These subtypes are characterised by different underlying mechanisms and can affect specific populations, such as older individuals or those with diabetes.

While atherosclerosis and arteriosclerosis are distinct conditions, they often coexist and contribute to plaque buildup in the arteries. This buildup can have serious health consequences, including an increased risk of stroke, heart attack, and other cardiovascular events. Therefore, understanding and managing these conditions are crucial for maintaining cardiovascular health.

Atherosclerosis is caused by a buildup of plaque in the inner lining of an artery

Atherosclerosis is a slow, complex disease that can start as early as childhood and typically progresses with age. It is often referred to as the hardening of the arteries and can lead to heart disease and stroke. Atherosclerosis usually affects large and medium-sized arteries.

The plaque can thicken the artery wall to the point of decreasing blood flow, which can cause an ischemic stroke. Atherosclerosis can lead to two types of ischemic strokes: atherothrombotic strokes and embolic strokes. Atherothrombotic strokes occur when plaque in a blood vessel breaks, and blood clots form at the rupture site, blocking blood flow. Embolic strokes happen when a blood clot or other particles break away from the rupture site and lodge in an artery leading to or in the brain, blocking blood flow.

In addition to strokes, severe artery blockage due to plaque buildup can cause a heart attack, aneurysm, or blood clot.

A stroke occurs when blood flow to the brain is blocked or there is bleeding in the brain

Plaque, or atherosclerosis, is the buildup of cholesterol, calcium, and other fatty substances in the arteries. This buildup can start as early as childhood and progress with age. Over time, the plaque can thicken the artery walls, reducing blood flow and oxygen supply to the brain.

When plaque builds up in the arteries, it can lead to two types of ischemic stroke. Atherothrombotic stroke is the most common, where a rupture of plaque in a blood vessel causes a blood clot to form. These clots can grow large enough to reduce or completely block blood flow to the brain.

Another type of ischemic stroke is an embolic stroke, where a blood clot or other particle breaks away from the rupture site and travels through the bloodstream. When it lodges in an artery leading to or within the brain, it blocks blood flow and results in a stroke.

Symptoms and Treatment of Stroke

The symptoms of a stroke include weakness or numbness in the face, arm, or leg on one side of the body, loss of vision, speech difficulties, sudden severe headaches, loss of balance, and confusion or agitation. Treatment for stroke includes medications such as antiplatelet and anticoagulant drugs, and procedures such as thrombectomy, angioplasty, and stenting to restore blood flow to the brain.

Preventing Plaque Buildup and Stroke

The risk factors for plaque buildup include high blood pressure, high cholesterol, unhealthy eating habits, and older age. By controlling these risk factors through lifestyle changes, such as a healthy diet, weight management, regular exercise, and smoking cessation, the risk of plaque buildup and stroke can be significantly reduced.

A transient ischemic attack (TIA) is a mini-stroke that temporarily blocks blood flow to the brain

A transient ischemic attack (TIA) is a temporary blockage of blood flow to the brain. It is often referred to as a "mini-stroke", but it is a serious medical condition that requires immediate attention. During a TIA, the blood supply to a part of the brain is disrupted for a brief period, typically lasting from a few minutes to up to 24 hours. Most TIA symptoms last for only about 1-2 hours and then disappear on their own, with no lasting damage to the brain.

TIAs are caused by a temporary reduction in blood flow to a portion of the brain, usually due to tiny blood clots that occlude an artery supplying blood to the brain. The primary blood supply to the brain comes from two carotid arteries in the neck, which branch off into multiple arteries within the brain. When a TIA occurs, this temporary disturbance results in a sudden, brief decrease in brain function.

The symptoms of a TIA are similar to those of a stroke and can include weakness or paralysis on one side of the body, slurred speech, blindness, severe headache, changes in alertness, sensory changes, mental confusion, memory loss, muscle weakness, dizziness, and coordination issues. It is important to seek immediate medical attention if any of these symptoms are present, even if they seem to go away, as a TIA can be a warning sign of a potential stroke in the near future.

High blood pressure is the main risk factor for TIAs and strokes. Other major risk factors include irregular heartbeat (atrial fibrillation), family history of stroke, tendency to form abnormal blood clots, increasing age (especially over 55), ethnicity (with African Americans at higher risk), recreational drug use, and a history of prior TIA or stroke.

While TIAs themselves do not cause permanent brain damage, they indicate an underlying issue that requires medical attention. Treatment options may include medications such as aspirin and other antiplatelet drugs, blood pressure medications, statins, and blood thinners. In some cases, catheter-based procedures or surgery, such as carotid endarterectomy, may be recommended to remove plaque buildup and improve blood flow to the brain.

Treatments for plaque buildup include stents, carotid endarterectomy, lifestyle changes, and medications

Stents

Stents are small, flexible, mesh-like tubes inserted into an artery under local anaesthesia. The tube is then expanded over a balloon to open up the blockage and improve blood flow. Stents are the simplest way to treat a blockage and are less invasive than other methods. However, the recurrence rate of plaque buildup is higher with stents because the artery remains smaller than its original size.

Carotid Endarterectomy

Carotid endarterectomy (CEA) is a surgical procedure to treat carotid artery disease, which is caused by the narrowing of the carotid arteries due to plaque buildup. During CEA, the surgeon makes an incision on the side of the neck over the affected carotid artery, opens the artery, and removes the plaque. The artery is then stitched back together, restoring normal blood flow to the brain. This procedure can be performed under local or general anaesthesia.

Lifestyle Changes

Lifestyle changes, such as following a healthy diet, quitting smoking, and increasing physical activity, can help prevent and treat plaque buildup. A Mediterranean diet, which is rich in olive oil, fruits, vegetables, nuts, and fish, can reduce the risk of heart disease. Smoking damages the lining of arteries, so quitting can help raise HDL ("good" cholesterol) levels. Regular aerobic exercise can also raise HDL levels, lower blood pressure, burn body fat, and lower blood sugar levels.

Medications

Medications such as statins (e.g., atorvastatin and rosuvastatin) are often used to reduce LDL ("bad" cholesterol) levels and prevent plaque buildup. These drugs block the liver enzyme that promotes cholesterol production.

Frequently asked questions