Being alive and living are two different things. Atherosclerosis is an epidemic in this country. Atherosclerosis leads to cardiac, cerebrovascular, and peripheral arterial disease (PAD). Cardiovascular disease is the number one killer in the US (600,000 deaths /year). Stroke is the third leading cause of death in the US (150,000 deaths/year). A stroke not only causes death (20% will die within 30 days)but also disability. This disability may be temporary or permanent and include inability to talk , swallow, walk, or use your arms. Peripheral artery disease or PAD can be disabling and even lead to limb loss. PAD is also a strong indication that there may be atherosclerosis in other blood vessels (ie heart and carotids). Abdominal Aortic Aneurysms is the silent killer and is responsible for about 15,000 deaths per year.
Patients who recognize they are at risk for atherosclerosis and are tested can make life style changes and receive medical treatment that can alter the progression and outcome of this disease process.
1. Recognize your Risks: Classically hypertension, Diabetes, hyperlipidemia and smoking are associated with atherosclerosis. These factors not only contribute to atherosclerosis individually but combined can cause more severe disease or more rapid progression.
Hypertension is defined as a BP > 140/90 or a BP > 130/80 if you are a diabetic. High blood pressure if left untreated will often lead to vascular disease involving the heart, brain, kidneys and lower extremities. Most individuals who have high blood pressure do not have their blood pressure under control.
Smoking: Smoking is the most important risk factor for the development of atherosclerosis. Individuals that smoke are a much greater risk of developing CAD, PAD, AAA and cerebrovascular disease.Tobacco smoke has severe adverse effects on blood vessels throughout the body. Combined with other risk factors smoking has an even greater pathologic effect on your blood vessels.Smoking is the most important modifiable risk factor in the treatment of vascular disease.
Diabetes: 25 million Americans that are effected by Diabetes. The great majority of diabetics (90%) are non insulin dependant type II. Type II Diabetes is associated with morbidity, hypertension, race and a family history. Diabetics have a much higher incidence of PAD, CAD and cerebrovascular disease. More than 80% of all amputations in the US are performed on patients with diabetes.
Hyperlipidemia: Abnormal cholesterol and triglyceride levels are a major factor in the development of atherosclerosis. Men 35 and older and woman 45 and older should have a lipid screening panel drawn. Based on the proportion of your good vs bad cholesterol as well as other cardiac risk factors an effective treatment plan can be started to optimize your good and bad cholesterol.
2. Abdominal Aortic Aneurysm (AAA): Abdominal aortic aneurysm is an enlargement of the aorta to a size greater than 3 cm. As the Aorta enlarges the wall weakens increasing the risk of rupture. There are 15,000 deaths a year in the US from aortic aneurysms. It is the 5th leading cause of death in males. In fact Medicare will pay for AAA testing for any male over the age of 65 who has ever smoked . Recognizing the presence of an AAA can lead to life saving intervention. Most AAA can be repaired minimally invasive with an endovascular approach. . If an AAA ruptures the likelihood of dying exceeds 80%.
3. Cardiac Disease: Cardiac disease is the leading cause of death worldwide. In the US cardiac disease is responsible for greater than 40% of all deaths a year (about a 600,000 annually). Twenty five percent of cardiac deaths occur in individuals who were not known to have cardiac disease.
Carotid Disease: Stroke is the third leading cause of death in the US. The majority (80%) of strokes are related to atherosclerosis and hypertension which affect the blood vessels supplying the brain. This includes the carotid arteries which are the main suppliers of blood to the brain. Carotid artery disease is often asymptomatic even at advanced stages. Ultrasound imaging ( a painless highly accurate test) of the carotid arteries is extremely effective at identifying disease. Depending on the degree of stenosis and symptoms patients can be treated medically or surgically. At specific degrees of stenosis particularly in combination with symptoms patients’ risk of stroke can be lessened significantly with surgical intervention.
4. Extremity: Peripheral artery disease (PAD) affects over 12 million Americans. Risk factors for PAD are smoking, high blood pressure, high cholesterol, and diabetes. Individuals with PAD may remain asymptomatic even with fairly advanced disease. Symptoms of PAD include pain in leg muscles with walking. For every one individual with symptomatic PAD there are three people with asymptomatic PAD. PAD is also a very important marker or predictor of systemic atherosclerosis. Sixty percent of individuals with PAD will also have cardiac and cerebrovascular disease. PAD can be detected with simple blood pressures checks in the arms compared to pressures at different levels in the legs. This is called an ankle-brachial index (ABI). This test is easy and reliable in detecting PAD and following it long term. Rocognozin and treatment of PAD can lessen your chance of stroke or cardiac death. Advanced PAD can be very disabling and can lead to limb loss. Surgical treatment most often endovascular ( minimally invasive) can improve blood flow to help improve ones quality of life. In very advanced cases where limbs are at risk , surgical treatment can improve blood flow so that amputation is avoided.
Collom and Carney Vascular Associates would like to help you live a healthier more active life. We are dedicated to identifying patients at risk for cardiovascular and cerebrovascular disease. Our doctors and staff will provide comprehensive , state of the art vascular management.
If you think you or a loved one is at risk for atherosclerosis call Today