What You Can Do to Prevent Atherosclerosis

Preventing atherosclerosis is based on basic lifestyle changes such as adopting eating habits that protect cardiovascular health, making regular physical activity a part of life, avoiding smoking and tobacco products completely and managing stress properly. In addition to these proactive steps, early diagnosis and effective treatment of chronic conditions that predispose to atherosclerosis, such as high blood pressure, high cholesterol and diabetes, under the supervision of a specialist is the most effective way to slow the build-up of plaque on the vessel walls and prevent serious consequences such as heart attack or stroke.

What is Atherosclerosis and Why Does It Occur?

We can think of atherosclerosis as a chronic problem affecting our body’s arteries, the pipelines that carry clean blood. This condition, medically known as atherosclerosis, occurs over time when a sticky layer called “plaque” builds up on the inner walls of these vessels. These plaques are a mixture of excess fat, cholesterol, calcium and cellular waste circulating in the blood.

The process can be likened to the buildup of lime and rust in a water pipe over time. The vessel wall, which is initially smooth and flexible, thickens, hardens and loses its flexibility as these plaques build up. The space inside the vessel gradually narrows and it becomes difficult for blood to flow freely to the organs. This is where the term “arteriosclerosis” comes from.

This process usually begins at a young age, even in childhood, and progresses silently over many years. The first step is damage to the delicate “endothelium” lining the inner surface of the blood vessel. The main initiators of this damage are factors that we can usually control: high blood pressure, chemicals in cigarette smoke, high cholesterol and uncontrolled diabetes. As the body tries to repair this damage, the process spins out of control and the cholesterol and cells adhering to the damaged area turn into a ball of plaque that grows over time. The danger is that these plaques suddenly crack and rupture. The body recognizes this as bleeding and tries to close the wound by forming a clot. However, this clot can completely block the already narrowed blood vessel, leading to life-threatening conditions such as heart attack or stroke.

What are the Symptoms of Vascular Occlusion and Which Parts of the Body Does It Affect?

Vascular blockage is considered a “silent” disease because it usually does not cause symptoms until there is not enough blood supply to the affected organ. Symptoms vary greatly depending on where in the body the blockage is located. Symptoms of atherosclerosis in the heart and symptoms of atherosclerosis in the leg are completely different.

The main areas affected and common symptoms are as follows:

Vessels Feeding the Heart (Coronary Arteries)

The narrowing of the heart vessels cannot meet the heart’s increased need for blood, especially during physical activity. There are typical symptoms of this condition:

• Feeling of pressure in the chest
• Jamming or weight
• Burning sensation
• Pain radiating to the left arm, back, neck or jaw
• Shortness of breath
• Abnormal fatigue

Vessels to the Brain (Carotid and Cerebral Arteries)

When the carotid arteries in the neck or blood vessels in the brain become blocked, brain cells are deprived of oxygen. Symptoms of cerebrovascular occlusion usually start suddenly and require urgent intervention:

• Sudden numbness in the face, arm or leg on one side of the body
• Weakness or paralysis
• Difficulty speaking or difficulty understanding what is being said
• Sudden and severe headache
• Dizziness or loss of balance
• Sudden loss or blurring of vision in one or both eyes

Leg, Arm and Foot Veins (Peripheral Arteries)

In this condition, which usually affects the legs, there is not enough blood supply to the muscles. Symptoms of foot vascular occlusion occur especially when walking:

• Painful cramps in the legs or buttocks when walking or climbing stairs (claudication)
• Pain that goes away at rest
• Coldness in the legs or feet
• Pale or bluish skin color
• Wounds on the toes or legs that do not heal
• Slow growth of toenails
• Loss of hair on the legs

Which Non-Modifiable Factors Increase the Risk of Atherosclerosis?

Some risk factors are beyond our control. Even if we cannot change them, knowing them allows us to focus more on the areas we can control.

• Advancing age: Over the years, our blood vessels naturally lose their elasticity and become more prone to plaque build-up. The risk increases significantly after the age of 45 in men and 55 in women after menopause.
• Family History (Genetic Predisposition): If you have a family history of heart disease at an early age, your risk is also increased. Diagnosis of heart disease in first-degree male relatives (father, brother) before the age of 55 and in female relatives (mother, sister) before the age of 65 is an important sign of genetic predisposition.
• Gender: Men generally have a higher risk of developing atherosclerosis than women. However, with the decrease in the protective effect of the hormone estrogen after menopause in women, this difference closes and the risk increases rapidly.

What are the Triggers and Controllable Risks for the Development of Atherosclerosis?

The good news is that many of the most important contributing factors to atherosclerosis are directly related to our lifestyle choices and can be controlled. These factors are closely interlinked; correcting one usually has a positive effect on the others.

Here are the most important risk factors you can manage:

• Smoking and use of other tobacco products
• High blood pressure (Hypertension)
• High levels of “bad” cholesterol (LDL)
• Low levels of “good” cholesterol (HDL)
• High triglyceride (blood fat) levels
• Diabetes and insulin resistance
• Overweight and obesity (especially abdominal fat)
• Physical inactivity (sedentary lifestyle)
• A diet rich in processed foods, saturated fat and trans fat
• Excessive salt consumption
• Excessive sugar consumption
• Chronic and unmanaged stress
• Insufficient or poor quality sleep
• Sleep apnea
• Excessive alcohol consumption

How Can Vascular Occlusion Be Prevented with a Heart-Friendly Diet?

What we eat directly affects our blood pressure, cholesterol, blood sugar and weight – the cornerstones of atherosclerosis. Nutrition is therefore our most powerful weapon in protecting vascular health. The goal is to choose natural and fresh foods with high nutritional value instead of processed, packaged and “empty calorie” foods. The scientifically proven Mediterranean and DASH diets provide a great roadmap.

Here’s what you should include in your diet to protect your arteries:

• Plenty of various vegetables (spinach, broccoli, cabbage, tomatoes, peppers)
• Fresh fruits (especially berries, apples, citrus fruits)
• Whole grains (whole wheat bread, oats, buckwheat, quinoa)
• Legumes (lentils, chickpeas, beans)
• Healthy sources of fat (extra virgin olive oil, avocado)
• Oily fish (salmon, sardines, mackerel – source of Omega-3)
• Raw nuts such as walnuts, almonds, hazelnuts
• Seeds (flax seeds, chia seeds)

Here’s what you should limit or avoid in your diet:

• Sugary drinks and ready-to-drink juices
• Refined carbohydrates such as white bread, bakery products
• Processed meat products such as salami, sausage, pepperoni
• Fatty parts of red meat
• Foods containing trans fats, such as fried foods and chips
• Saturated fats such as butter, tail fat
• Full-fat dairy products
• Ready-made sauces, marinades and packaged foods containing excess salt

How Regular Physical Activity Protects Vascular Health

Movement is the most natural medicine for blood vessels. Regular exercise strengthens the heart muscle in the same way as when you work your muscles in a gym. The heart works more efficiently, pumping blood with less effort, which lowers blood pressure. Exercise also helps raise the “good” cholesterol HDL and lower the “bad” cholesterol LDL, helps control weight, reduces stress and regulates blood sugar. In short, it fights against all controllable risk factors in one single move.

The goal is to do at least 150 minutes of moderate-intensity activity per week. This equates to about 30 minutes of brisk walking a day. Remember that even the smallest movement is better than no movement at all.

Here are activities you can do for your vascular health:

• Brisk walking
• Swimming
• Cycling
• Dancing
• Gardening
• Light jogging (Jogging)
• Weight or resistance training two days a week (to maintain muscle mass)
• Yoga or Pilates (for flexibility and balance)

Why and How Fast Does Quitting Smoking Lower the Risk of Atherosclerosis?

Smoking is the worst thing you can do to your blood vessels. The thousands of toxic chemicals in tobacco smoke directly destroy the lining of blood vessels, making the blood stickier and more prone to clotting, instantly raising blood pressure and upsetting the cholesterol balance. Even passive smoking significantly increases the risk.

Quitting smoking is the most important step you can take to reverse this damage. Your body’s capacity to repair itself is incredible and the benefits start within minutes of your last cigarette. Within 1-2 years of quitting, your risk of heart attack is significantly reduced. after 15 years, your risk of coronary artery disease approaches that of a person who has never smoked. This is the strongest evidence that it is never too late.

Why Stress Management and Adequate Sleep Are Critical to Preventing Atherosclerosis

The effects of stress and lack of sleep on heart health are now proven. Chronic stress creates a constant “fight or flight” response in the body. This keeps levels of stress hormones such as cortisol high. High cortisol directly feeds the atherosclerosis process by increasing blood pressure, blood sugar and inflammation in the arteries.

Similarly, insufficient and poor quality sleep impairs the body’s ability to repair and regulate itself. 7-9 hours of quality sleep a night is essential for regulating blood pressure, balancing hormones and resting the brain.

Here are some ways you can cope with stress and improve the quality of your sleep:

• Deep breathing exercises
• Meditation
• Spending time in nature
• Spending quality time with your loved ones
• Take up a hobby
• Going to bed and getting up at the same time every day
• Avoiding screens (phone, TV) before going to bed
• Avoiding short naps during the day

How Alcohol Consumption Affects Vascular Health

The relationship between alcohol and heart health is delicate. The old belief that “a glass of wine is good for the heart” is not supported by modern scientific evidence. The observed benefits are thought to be due to the fact that people who consume alcohol in moderation generally have healthier lifestyles, rather than the alcohol itself.

The harms of excessive alcohol consumption are clear. Alcohol raises blood pressure and triglyceride levels, can lead to heart arrhythmias and, due to its high calorie content, it also indirectly poses a risk by triggering weight gain. Therefore, if you do not consume alcohol, it is strongly discouraged for health reasons. If you do, it is safest to consume no more than one measure a day for women and two measures a day for men.

How to Detect Cardiovascular Blockage without Angiography?

This is one of the most common questions our patients ask. The answer to how to recognize blocked heart vessels does not always require an invasive procedure such as an angioplasty. In fact, modern medicine offers us many painless and risk-free ways to understand the condition of the vessels. The process usually starts with a detailed physician assessment and may include the following steps.

These are the methods that a specialist can use:

• Detailed Medical History and Risk Assessment: Your doctor will do an initial risk profile by listening to your symptoms, lifestyle and family history.
• Physical Examination: This includes basic steps such as measuring blood pressure and listening to heart and blood vessel sounds with a stethoscope.
• Blood Tests: Cholesterol (LDL, HDL), triglyceride and blood sugar (A1C) levels, inflammatory markers (CRP) are checked.
• Electrocardiography (ECG): Records the electrical activity of the heart and can indicate rhythm disturbances or a previous heart attack.
• Effort Test (Stress Test): Measures the performance of the heart under load on a treadmill under ECG monitoring. Hidden vascular stenoses may become apparent during this test.
• Echocardiography (ECHO): Ultrasound of the heart. It shows the structure and contractile strength of the heart muscle and valves.
• Doppler ultrasound: It can detect severe stenosis by measuring blood flow in the neck (carotid) or leg arteries with sound waves.
• CT (Computed Tomography) Angiography: This advanced CT scan, performed by administering a contrast agent intravenously, creates three-dimensional images of the coronary vessels and clearly shows plaque, calcification and stenoses. It is a powerful test that can give very detailed information about the vessels without the need for angiography.

Which medicines are used in the treatment of vascular occlusion?

Lifestyle changes are the basis of treatment, but alone may not be enough. Medication is often necessary, especially to control the so-called “big three”: high blood pressure, high cholesterol and diabetes. These drugs intervene at different points in the atherosclerosis process, slowing disease progression and reducing risks.

The main groups of medicines used in treatment are as follows:

• Cholesterol-lowering drugs (statins): They reduce the production of the “bad” cholesterol LDL, the main component of plaques. They also reduce the risk of rupture by stabilizing existing plaques.
• Antihypertensives (Blood Pressure Drugs): Lower blood pressure through different mechanisms, preventing constant stress and damage to the vessel walls.
• Antiplatelets (clot busters): Drugs such as aspirin reduce the risk of clot formation by preventing blood platelets from sticking together. They play a particularly critical role in lowering the risk of heart attack or stroke.
• Diabetes Medicines: By keeping blood sugar under control, they prevent the damage caused by sugar to the vessel walls.

How to Open a Cardiovascular Blockage: What is Angioplasty, Stent and Bypass?

In the case of critical vascular stenoses that cause severe symptoms or pose a risk of heart attack despite medication and lifestyle changes, interventional procedures are used to open the blockage.

• Balloon Angioplasty and Stent: This procedure is performed during angiography. The heart is accessed with a thin catheter through the groin or arm vein. A small balloon at the tip of the catheter is inflated at the point of stenosis, the plaques are crushed against the vessel wall and the vascular access is opened. Usually, a small wire tube, called a “stent”, is permanently inserted into the vessel to prevent re-narrowing. The stent acts as a scaffold for the vessel, keeping it open.
• Coronary Bypass Surgery: This is an open-heart surgery that is usually preferred when the stenoses are multiple, widespread or not suitable for stenting. The idea is to “bypass” the blocked vessel with a bridge. A healthy piece of blood vessel from another part of the body (usually a chest wall artery or a vein from the leg) is sewn ahead of the blockage. Blood then flows through this newly created “bypass” pathway and continues to supply the heart muscle. Especially in patients with multivessel disease or diabetic patients, bypass surgery can offer more permanent and effective results than stenting in the long term.