Healthy arteries are flexible, muscular tubes, which have a smooth lining called the intima. The arteries' elasticity allows them to take up the shock of each heartbeat and recoil between beats, enabling them to deliver the blood in a steady flow. As we grow older, the intima gets thicker and may also become roughened (known as arteriosclerosis). This loss in elasticity means that the blood is delivered to the body's tissue in sluggish spurts. If the diet is laden with cholesterol, deposits may get caught on the roughened surface, particularly at a bend or fork, forming plaques. These plaques gather more deposits, in the same manner that silt gathers in a river. This hardening of the arteries due to fatty deposits is known as atherosclerosis.
At this point, a number of things can happen. In most cases, the artery continues to narrow until the blood is moving slow enough to form a clot (a thrombosis). However, occasionally small pieces may break away from the obstruction, and be carried along with the blood until they reach a smaller, half-blocked blood vessel, where they completely cut off the blood supply to the tissues that depend on that artery. This is known as an embolism.
Although plaques begin to form in the arteries around adolescence, there are a number of factors that present a high risk of developing atherosclerosis. These include those who:
- are over the age of 50
- are male
- smoke heavily
- drink heavily
- have a diet rich in saturated fats
- have diabetes
- have high blood pressure
- are obese
- have a sedentary life-style
- have close relatives who have had some complication of atherosclerosis (such as stroke or coronary heart disease)
- have symptoms of clinical depression or stress
- have high levels of homocysteine
- have dyslipidemia (elevated serum cholesterol or triglyceride levels)
- have high levels of uric acid
- have hypothyroidism
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