ATHEROSCLEROSIS

ATHEROSCLEROSIS By Dr.B.Karthik kumar MD(s) NanjuNool Department

Sincere Thanks to Prof .Dr.M.Murugesan,MD(s) Dean,HOD Department of nanju nool Lecturers • Dr.R.Madhavan MD(s) • Dr.P.Shanmugha priya MD(s) • Dr.V.Manjari MD(s) • Dr.S.Murugesan MD(S)

DEFINITION • Atherosclerosis is characterized by localized fibrous thickenings of the arterial wall associated with lipid infiltrated plaques that may eventually calcify…… • Life threatening disease of heart and brain because of formation of intravascular clot at the site of plaques

Mortality “Cardiovascular disease claimed 39.4 percent of all deaths or 1 of every 2.5 deaths in the United States in 2000. CVD was about 60 percent of “total mention mortality.” This means that of over 2,400,000 deaths from all causes, CVD was listed as a primary or contributing cause on about 1,415,000 death certificates.” (American Heart Disease)

BLOOD VESSEL • The blood vessels are a closed system conduits that carry blood from heart to the tissue and back to the heart • The wall of Aorta and large arteries contain abundant elastic tissue , much concentrated as Internal elastic lamina b/w Intima and media and External elastic lamina b/w media and adventia • Systole • Diastole Nerve fibres Mainly innervated by nor adrenergic nerve fibre – vaso constriction Some instances Cholinergic nerve fibres – vaso dilation

PATHOGENESIS • Condition begins in childhood and in the absence of accelerating factors develop slowly until it is wide spread in old age. • Initial event - infiltration of LDL into sub endothelial region • Endothelium is subjected to shear stress , it cause tendency to pull in to the flowing blood • The LDL are oxidized or altered in other ways • Altered LDL activate various component of innate Immune system (Macrophages, natural antibodies,CRP, Complement. • Scavenger receptors uptake the altered LDL into macrophages and formation of foam cells which forms fatty streaks

APPEARANCE OF FATTY STREAKS Aorta – 1ST DECADE Coronary artery – 2nd DECADE Cerebral artery – 3rd & 4th DECADE Note 1 Decade = 10 years

CLINICAL MANIFESTATION • Coronary artery – 75% angina pain (M.I) • Cerebral circulation – Stroke • Abdominal Aorta – Anuerysnal dilation, rupture of vessel • Renal vessel – Renovascular hypertension • Circulation to leg Vascular insufficiency cause intermittent claudication • Severe skin can ulcerate producing lesion that are slow to heal • Frauk gangrene of the extremities

RISK FACTORS

cont…

measures Electro- cardiogram Stress Test shows measures Coronary Angiography specific blood electrical coronaries to heart Sites of supply impulses Narrowing in Screening and Diagnosis

Other Tests Include... • Blood tests: used to evaluate kidney and thyroid function as well as to check cholesterol levels and the presence of anemia. • Chest X-ray: shows the size of your heart and whether there is fluid build up around the heart and lungs. • Echocardiogram: shows a graphic outline of the heart’s movement • Ejection fraction (EF): determines how well your heart pumps with each beat.

Drugs • Drugs that inhibit hepatic 3 methyl glutaryl coenzyme A (HMG-CoA) • Atorvastatin • Lovastatin • Pravastatin • Simvastatin • Flovastatin • rosuvastatin

Siddha drugs • Increased kapha kuttram in the blood vessel (atherosclerosis) • Hence drug should be administered to reduce kapa humour and to increase free flow of blood • Kadukkai leghyum – 5gm with hot water in night after food • Kollu kasayam - 60 ml b.d before food • Natthaicuri curnam – 5gm with honey b.d after food • Trithoda tab – 1-0-1 with hot water b.d after food • Marutham tab – 2-0-2 with hot water after food • Mantharai guggulu – 2-0-2 with hot water after food • Tpr - 5gm b,d after food • Pundu then – 5ml b.d after food

Atherosclerosis Vs Exercise • Exercise helps prevent atherosclerosis in a number of ways. It keeps arteries healthy by lowering bad cholesterol and boosting good cholesterol. And it reduces other risk factors for atherosclerosis and blood clots, such as high blood pressure, diabetes, obesity, and stress. • Regular exercise also helps arteries by boosting the production of nitric oxide by the cells lining the arteries, which helps circulation. And new research in mice suggests that exercise stimulates the bone marrow to produce new cells for the arterial lining, which replace aging cells and repair damaged arteries.

Yogas preventing atherosclerosis

How Does Yoga Help In Combating This Disease? • A study, published in Journal of The Association of Physicians of India (JAPI), establishes the reversibility of heart disease through yoga. Study was on angiographic ally proven CAD patients, of whom 71 formed the study group and 42 the control group. And the results proved that the serum total cholesterol levels had reduced by 23.3%, disease had regressed in 43.7% and progression was arrested in another 46.5% of the patients. Some marked improvements were noticed in anxiety levels of patients. Controlled yoga combining calming and stimulating measures resulted in reduced serum cholesterol, LDL and triglyceride levels.

Food substance preventing atherosclerosis

Rich in antioxidants, soluble fiber, flavonoids, potassium, and the B-vitamin folate, they also contain substances that improve blood flow, strengthen blood vessels, lower blood pressure, and relax the involuntary muscles inside the arteries that would otherwise cause arteries to go into spasm. • The allium family is a star when it comes to fighting arteriosclerosis. Garlic and even onions have been clinically proved to reduce the "bad" LDL (low-density lipoprotein) cholesterol and increase the "good" HDL (high-density lipoprotein) cholesterol. Only raw or cooked garlic, not garlic oil, appears to have this effect. Press or chop the garlic so that its beneficial allicin is released. The key is breaking up the cells of the garlic

Soluble fiber is the type that helps lower blood cholesterol levels. Good sources include apples, carrots, cruciferous and nightshade vegetables (see food profiles), melons, sweet potatoes, and squash • All fresh fruits and vegetables contain potassium, which normalizes blood pressure and helps maintain a regular heartbeat.

Eat more fish. Fish is a good source of protein and other nutrients. It also contains omega-3 fatty acids, which may help reduce the risk of heart disease and stroke. The American Heart Association recommends two servings a week of omega-3 fatty acid-rich fish like salmon. • Eat more vegetables, fruits, whole grains, and beans. These beautiful and delicious wonders of nature may be one of the most powerful strategies in fighting heart disease. • Choose fat calories wisely • Eat a bare minimum of saturated fats and trans fats (for example, fats found in butter, hard margarine, salad dressing, fried foods, snack foods, sweets, and desserts).

Eat a variety -- and just the right amount -- of protein foods. Commonly eaten high-fat protein foods (meat, dairy products) are among the main culprits in increasing heart disease risk. Reduce this nutritional risk factor by balancing animal, fish, and vegetable sources of protein and choosing the leanest protein sources. • Limit cholesterol consumption. Limiting dietary cholesterol has an added bonus: You'll also cut out saturated fat, as cholesterol and saturated fat are usually found in the same foods. Get energy by eating complex carbohydrates (whole-wheat pasta, sweet potatoes, whole-grain breads) and limit simple carbohydrates (regular soft drinks, sugar, sweets). The American Heart Association says it is OK to have an egg a day if your cholesterol is normal. When it comes to lowering blood cholesterol levels, limiting saturated fats is more important than dietary cholesterol intake. The recommendation is not to exceed 300 milligrams of dietary cholesterol each day. • O

Fruits Vs atherosclerosis

Papaya Vs Artery C.S

Get regular medical checkups. • Control your blood pressure. • Check your cholesterol. • Don’t smoke. • Exercise regularly. • Maintain a healthy weight. • Eat a heart-healthy diet. • Manage stress. Prevention

ATHEROSCLEROSIS