ARTERY BLOCKAGE

Building of plaque in arteries is medically termed atherosclerosis.
It cannot be reversed with minimal invasive intervention like stenting or medication with statins.
Prevention of the accumulation of new plaque that causes blockages over time, reduces the chances of a future heart attack.
Therapies alone cannot stop plaque formation unless they are backed by a healthy lifestyle, low stress, zero smoking, the right diet, moderate exercise, weight control, and diabetes & hypertension management.

Heart maintenance depends on a multiplicity of factors.
An angiography showed that clots decreased by a minuscule 5% in 30% of the group.
Howsoever slim the person is, there was a greater chance of reversal after five years than after one year.
The sustained lifestyle choices over a long period can prevent a worsening of plaques on the understanding that they were non-threatening in the first place.
It should be clear that we cannot afford to chase theories among high-risk Indians, who are likely to manifest heart conditions at least 10 years earlier than people in other geographies.
Only medication & specialized cardiac intervention can save lives.
Indians need to look at two issues that Indians need to prioritise: i) that of cholesterol, particularly the low-density lipoprotein (LDL) that accelerates plaque build-up; ii) stabilize existing plaque since we cannot make it disappear.

Plaque forms when cholesterol clings to the wall of the artery, thickening & hardening it.
In self-defence, the body sends white blood cells to trap the cholesterol, which then balloons up, causing inflammation.
This then triggers the muscle cells to multiply & cap the area.
Larger plaques can constrict the arteries & reduce blood flow.
Since they are covered by these fibrous caps, they do not break apart easily.
Stenting near the blockages widens the artery.
Smaller, unstable plaques are dangerous as they can rupture with any trigger, detach themselves in the middle, completely blocking blood flow, leading to an acute heart attack, stroke or death.
Cardiologists target these unstable plaques, which can be risky at even 30% blockage.
The idea is to suck out the cholesterol from the inside & is not threatening anymore.

By lowering cholesterol levels in the blood, where it travels inside particles called lipoproteins, LDL levels can be lowered.
Of these LDLs are the worst culprits, depositing cholesterol in blood vessel walls.
Hence statins are needed to block liver enzymes that promote cholesterol production & inhibit cholesterol absorption which cut LDL & even stabilizes it.
If one is diagnosed with a heart condition, the LDL levels should be below 60 mg/dL.
The lower the LDL levels, the it is more likely to halt the plaque from growing.
Usually, LDL levels of less than 70 mg/dL are preferred, but for Indians, it should be less than 50 mg/dL.
Indians need to work towards this LDL goal at a younger age so that blockages do not develop at all.
LDL levels among all Indians need to be reworked in combination with co-morbidities, high triglycerides & body weight.
Although there is no linear correlation between triglycerides & atherosclerosis, it is linked to pancreatitis.
When the pancreas is inflamed, it can release inflammatory cells & toxins that could harm vital organs.

Persons with less cholesterol may look at all risk factors together & then determine to do further testing.
This could include a CT scan of the heart, a treadmill test, an MRI & a carotid ultrasound.
It is needed to start lipid-lowering drug therapies early on besides positive lifestyle changes for those at risk & presenting themselves with alarming scenarios.
Even those who are fit but have bad lifestyle markers need to get screened every six months.
A window of 3-6 months is allowed for lifestyle modifications for those who are not at high risk to correct themselves.
A massive lifestyle modification, no smoking, a vegetarian-rich diet except fish & chicken, a BP of 130/80 & medication are recommended.
Medication comes if these changes do not yield the expected results, surgical intervention is the last resort.
Stabilisation of plaque occurs within 3-6 months of beginning antilipidemic therapy.

Source:indianexpress

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