Atherosclerosis is a chronic condition characterized by the buildup of plaques within arterial walls. These plaques are composed of fat, cholesterol, calcium, and other substances found in blood. Over time, this deposit can harden and constrict the arteries, reducing blood flow to various organs and tissues. Atherosclerosis is a primary cause of many cardiovascular diseases, including coronary artery disease, stroke, and peripheral artery disease. As a cardiologist based in Singapore, I intend to provide a comprehensive explanation of this issue, including its causes, symptoms, diagnostic tools, and potential treatment options.

What Causes Atherosclerosis?

The formation of atherosclerosis is a complex process impacted by numerous factors:

1. High Cholesterol Levels: LDL cholesterol, sometimes known as “bad” cholesterol, is a major factor to plaque formation. When LDL cholesterol levels are high, it can deposit on artery walls, causing plaque accumulation.
2. Hypertension: High blood pressure can damage the artery’s inner lining, making it more prone to fat and cholesterol invasion.
3. Smoking: Tobacco smoke contains compounds that can damage blood vessels and promote plaque development. Smoking also lowers high-density lipoprotein (HDL), or “good” cholesterol, which aids in the removal of LDL cholesterol from the arteries.
4. Diabetes: High blood sugar levels can cause arterial wall damage and plaque formation. Diabetes is linked to other risk factors for atherosclerosis, such as high blood pressure and excessive cholesterol levels.
5. Obesity: Excess body weight, particularly in the abdomen, has been associated to elevated levels of LDL cholesterol and triglycerides, both of which lead to plaque formation.
6. Physical Inactivity: A lack of exercise can lead to obesity and raise the risk of high blood pressure, diabetes, and high cholesterol, all of which are risk factors for heart disease.
7. Unhealthy Diet: A diet heavy in saturated fats, trans fats, and cholesterol can lead to the formation of arterial plaques.
8. Genetic Factors: A family history of cardiovascular illness may raise the risk of developing atherosclerosis, indicating a genetic susceptibility.

What are the Symptoms of Atherosclerosis?

Atherosclerosis often develops gradually, and symptoms may not appear until the artery is considerably constricted or stopped. The symptoms differ based on which arteries are affected:

Coronary Arteries (Heart):

• Chest pain or angina
• Shortness of breath
• Heart attack

Carotid Arteries (Brain):

• Sudden weakness or numbness in the arms or legs
• Difficulty speaking or understanding speech
• Temporary loss of vision in one eye
• Drooping muscles in the face

Peripheral Arteries (Limbs):

• Leg discomfort while walking (claudication)
• Numbness or weakness in your legs.
• Coldness in the lower legs or feet
• Non-healing sores on toes, feet, or legs

Renal Arteries (Kidneys):

• High blood pressure
• Kidney failure
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How is This Condition Diagnosed in Singapore?

In Singapore, atherosclerosis is diagnosed using a combination of medical history, physical examination, and diagnostic testing. The technique is intended to determine the extent of the condition and the best treatment alternatives. Here are the often-used diagnostic methods:

• Medical History and Physical Examination: Your doctor will go over your medical history, including any symptoms, risk factors, and family history of cardiovascular disease. A physical examination will also be performed to look for symptoms of atherosclerosis, such as weak or absent pulses and poor wound healing.
• Blood Tests: Blood tests examine cholesterol, blood sugar, and other markers that may indicate atherosclerosis. Common signs include elevated LDL cholesterol and triglyceride levels.
• Electrocardiogram (ECG): Measures the electrical activity of the heart and can detect anomalies that may indicate coronary artery disease or past heart attacks.
• Ultrasound: ultrasonography imaging, such as carotid ultrasonography, can measure blood flow and diagnose arterial obstructions. This non-invasive examination uses sound waves to generate pictures of blood arteries.
• Ankle-Brachial Index (ABI): This test measures blood pressure in the ankle and the arm to detect peripheral artery disease. A substantial disparity in blood pressure readings may indicate obstructions in the arteries of the legs.
• CT Scan: A computed tomography (CT) scan can produce comprehensive images of the heart and blood vessels, allowing clinicians to detect calcified plaques and determine the severity of atherosclerosis.
• Magnetic Resonance Imaging (MRI): MRI creates detailed images of blood arteries by combining magnetic fields and radio waves. It can assist detect obstructions and evaluate blood flow.
• Angiography: Angiography is an invasive procedure that includes injecting a contrast dye into blood arteries and obtaining X-ray images. It generates precise images of the arteries and can detect blockages or constriction.

Atherosclerosis Treatment Options and Prevention in Singapore

Atherosclerosis treatment seeks to manage symptoms, eliminate risk factors, and prevent disease progression. Atherosclerosis treatment in Singapore consists of lifestyle modifications, drugs, and medical treatments.

Lifestyle Changes

• Healthy Diet: A nutritious diet that includes fruits, vegetables, whole grains, lean proteins, and healthy fats can help lower cholesterol and enhance cardiovascular health. Avoiding meals high in saturated fat, trans fat, and cholesterol is critical.
• Regular Exercise: Brisk walking, cycling, or swimming, can help you maintain a healthy weight, lower your blood pressure, and improve your cholesterol levels.
• Quit Smoking: Quitting smoking is critical for preventing future artery damage and boosting overall cardiovascular health. There are a variety of assistance programs and drugs available to help people quit smoking.
• Limit Alcohol Consumption: Drinking alcohol in moderation can help prevent high blood pressure and other risk factors for atherosclerosis.

Medications

• Statins: These drugs lower LDL cholesterol and help to stabilize plaques, lowering the risk of heart attack and stroke.
• Antihypertensives: Blood pressure-lowering medications can help lessen strain on the arteries and prevent additional damage.
• Antiplatelet Agents: Aspirin and other antiplatelet agents can help prevent blood clots from forming, lowering the risk of heart attacks and strokes.
• Diabetes Medications: To avoid blood vessel damage, people with diabetes must keep their blood sugar levels under control.

Medical Procedures

• Angioplasty and Stenting: This technique includes inserting and inflating a balloon catheter into a narrowed artery to enlarge it. A stent (a tiny mesh tube) is then inserted to keep the artery open.
• Coronary Artery Bypass Grafting (CABG): A surgical procedure that includes removing a blood vessel from another part of the body and utilizing it to bypass the blocked artery, allowing blood to flow around it.
• Carotid Endarterectomy: This surgical technique removes plaque from the carotid arteries to avoid strokes.
• Endovascular Therapy: Peripheral artery disease can be treated with minimally invasive techniques such as angioplasty and atherectomy.

Emerging Research and Innovations in Atherosclerosis Treatment

Emerging research and improvements in heart failure care show promise for better treatment and management, especially in light of Singapore’s rising incidence of heart failure. These discoveries have the potential to transform the treatment of heart failure, giving patients and healthcare providers new hope.

Gene Therapy

Gene therapy is one of the most promising new treatments for heart failure. This novel strategy entails changing or regulating genes to restore damaged heart tissue. Gene therapy is being investigated as a potential treatment for heart failure in Singapore. Scientists hope to create therapies for heart failure by targeting specific genes that regulate heart function.

Stem Cell Therapy

Stem cell therapy has great potential for regenerating heart muscle and healing tissue damage caused by heart failure. This treatment involves the use of stem cells, which have the ability to develop into numerous types of cells, to repair damaged cardiac tissue. For Singapore heart failure patients, stem cell therapy may be able to restore heart function and enhance quality of life. Ongoing clinical trials and research in are aimed at determining how to best use stem cells to achieve these goals of atherosclerosis treatment Singapore.

Innovative Medications

Another important area of progress is the discovery of novel drugs that target specific pathways implicated in heart failure. New medications are being developed to interact with molecular pathways that cause heart failure, providing more specific and effective treatment choices. These drugs could be critical in treating symptoms and decreasing disease progression in Singapore’s heart failure treatment procedures. For example, medications that target inflammation, fibrosis, or other pathological processes within the heart may provide significant advantages to patients.

Conclusion

Atherosclerosis is a serious and persistent disorder that requires prompt diagnosis and good treatment. Understanding the origins, symptoms, and treatment choices is critical for preventing disease development and lowering the risk of major cardiovascular events. In Singapore, improved diagnostic techniques and a comprehensive approach to treatment, including lifestyle changes, drugs, and medical procedures, provide hope to people suffering with atherosclerosis.

Individuals who address risk factors and live a heart-healthy lifestyle can greatly enhance their cardiovascular health and quality of life. For people seeking atherosclerosis therapy in Singapore, engaging with healthcare professionals and adhering to a specific treatment plan is critical for the best results.

If you’re noticing signs of heart disease or just want to check on your heart health, don’t hesitate to act. Reach out to the Harley Street Heart and Vascular Centre for a thorough evaluation. Call us at +65 6235 5300 to book an appointment with one of our distinguished cardiac specialists. Prioritize your heart health today—your well-being is our top priority!

Written by: Dr Michael MacDonald MB ChB, BSc (Hons), MRCP (UK), MD (Research), FESC (Europe).  Dr MacDonald was trained in the UK and is a senior Consultant Cardiologist.