Atherosclerosis is the common form of arteriosclerosis in which deposits of yellowish plaques (atheromas) containing cholesterol, lipoid material, and lipophages are formed within the intima and inner media of large and medium sized arteries. Complications of atherosclerosis account for 1/2 of all deaths, and 1/3 of deaths in persons between ages 35-65.
The cause of atherosclerosis is biochemical, physiologic, and environmental factors that lead to thickening and occlusion of the lumen of arteries. Atherosclerosis is considered to be a disease of aging since some degree of atherosclerosis is universal.
Risk factors include: Hypertension; Tobacco smoking; Diabetes mellitus; Obesity; Male gender; Physical inactivity; Increasing age; Family history of premature atherosclerosis; Decreased high-density lipoprotein (HDL) cholesterol; and Increased low-density lipoprotein (LDL) cholesterol
Three mechanisms have been identified as the most probable causative factors in the development of atherosclerosis: Oxidation of LDL cholesterol; Homocysteine overload; and Abnormal platelet aggregation (clotting inside an artery).
Linus Pauling proposed that atherosclerosis was due to sub-clinical scurvy (vitamin C deficiency). Vitamin C is needed to make collagen that forms (and repairs) blood vessels. Pauling also proposed that a deficiency of lysine allowed lipoprotein (A) to attach to the blood vessel walls and form plaques.
Angiographyand stress testing shows areas of severe narrowing (stenosis). The majority of events, however, occur due to atheroma plaque rupture at areas without narrowing sufficient enough to produce any angina or stress test abnormalities.
Lab tests are ordereed to identify underlying causes, which includes diabetes, hypertension, obesity, inflammation, etc.
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