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Atherosclerosis

Atherosclerosis is a disease affecting arterial blood vessel. It is commonly referred to as a "hardening" or "furring" of the arteries. It is caused by the formation of multiple plaques within the arteries. Pathologically, the atheromatous plaque is divided into three distinct components: more...

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The atheroma ("lump of porridge", from Athera, porridge in Greek,) is the nodular accumulation of a soft, flaky, yellowish material at the center of large plaques, composed of macrophages nearest the lumen of the artery, sometimes with underlying areas of cholesterol crystals and possibly also calcification at the base of older/more advanced lesions.

Arteriosclerosis ("hardening of the artery") results from a deposition of tough, rigid collagen inside the vessel wall and around the atheroma. This increases the stiffness, decreases the elasticity of the artery wall. Arteriolosclerosis (hardening of small arteries, the arterioles) is the result of collagen deposition, but also muscle wall thickening and deposition of hyaline cartilage.

Calcification, sometimes even ossification (formation of complete bone tissue) occurs in the thickest parts of sclerosed vessel wall.

Some sources draw a distinction between "Arteriosclerosis", "Atherosclerosis," and "Arteriolosclerosis". In these contexts, "Atherosclerosis" is used when referring to larger arteries, and "Arteriolosclerosis" is used when referring to arterioles, with "Arteriosclerosis" used as a parent of both terms. Atherosclerosis causes two main problems. First, the atheromatous plaques causes stenosis (narrowing) of the artery and, therefore, an insufficient blood supply to the organ it feeds. This complication is chronic, slowly progressing. A common scenario is claudication from insufficient blood supply to the legs. Second, the soft plaque may suddenly rupture (see vulnerable plaque), causing the formation of a blood clot (thrombus) that will rapidly stop blood flow, leading to death of the tissues fed by the artery. This catastrophic event is called an infarction. The most common scenario is a thrombosis of a coronary artery causing myocardial infarction (a heart attack).

Symptoms

Atherosclerosis typically begins in later childhood, is usually found in most major arteries, yet is asymptomatic and not detected by most diagnostic methods during life. It most commonly becomes seriously symptomatic when interfering with the coronary circulation supplying the heart or cerebral circulation supplying the brain, and is considered the most important underlying cause of strokes, heart attacks, various heart diseases including congestive heart failure and most cardiovascular diseases in general. Atheroma in arm or more often leg arteries and producing decreased blood flow is called Peripheral artery occlusive disease (PAOD).

According to United States data for the year 2004, for about 65% of men and 47% of women, the first symptom of atherosclerotic cardiovascular disease is heart attack or sudden cardiac death (death within one hour of symptom onset).

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Atherosclerosis and meditation
From Townsend Letter for Doctors and Patients, 2/1/05 by Robert A. Anderson

Psychosocial stress influences the development and progression of atherosclerosis. Carotid intima-media thickness (IMT) is a valid surrogate measure for coronary atherosclerosis, is a predictor of coronary outcomes and stroke and is associated with psychosocial stress factors. Sixty hypertensive subjects who were randomly assigned to either the Transcendental Meditation program or a health education control group completed pretest and posttest carotid IMT data determined by B-mode ultrasound. Mean maximum IMT from 6 carotid segments was used to determine baseline IMT values and those taken 6-9 months later. Age and pretreatment IMT were found to be predictors of posttest IMT values and were used as covariates. The TM group showed a significant mean decrease of 0.098 mm vs. an increase of .054 mm in the control group (2p=.038).

Castillo-Richmond A et al. Effects of stress reduction on carotid atherosclerosis in hypertensive African Americans. Stroke 2000 Mar; 31(3):568-73

COMMENT: We would expect the intima-medial thickness of the carotid arteries to gradually increase in hypertensive subjects and healthy individuals for that matter. The surprise here is the regression of thickening in those engaging in regular TM sessions. One would expect that other meditative approaches might have the same result, but they have been less well studied. Such striking data will not be accepted in the mainstream without further larger controlled studies. In the meantime, given the fact that meditation has numerous other proven benefits and no downside, why not recommend it to patients who are interested? A feasible mechanism can also be postulated. Catecholamines, the degradation of which fuels oxidative stress, are markedly reduced in regular meditators.

COPYRIGHT 2005 The Townsend Letter Group
COPYRIGHT 2005 Gale Group

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