Name

: MELINDA Wulandari

Major

: NURSING

Atherosclerosis
Atherosclerosis is a condition that develops when a substance called
plaque builds up in the walls of the arteries. This buildup narrows the arteries,
making it harder for blood to flow through. Atherosclerosis is the usual cause
of heart attacks, strokes, and peripheral vascular disease -- what together are
called "cardiovascular disease." Cardiovascular disease is the No. 1 killer in
America, with more than 800,000 deaths in 2005.
Arteries are blood vessels that carry blood from the heart throughout the
body. They're lined by a thin layer of cells called the endothelium. The
endothelium works to keep the inside of arteries toned and smooth, which keeps
blood flowing. According to experts, atherosclerosis begins with damage to the
endothelium caused by high blood pressure, smoking, or highcholesterol. That
damage leads to the formation of plaque. When bad cholesterol, or LDL, crosses
the damaged endothelium, thecholesterol enters the wall of the artery. That causes
your white blood cells to stream in to digest the LDL. Over years, the
accumulating mess of cholesterol and cells becomes a plaque in the wall of the
artery. Plaque is a jumble of cholesterol, cells, and debris that creates a bump on
the artery wall. As atherosclerosis progresses, that bump gets bigger. And when it
gets big enough, it can create a blockage.
A family history of cardiovascular disease, smoking, stress, obesity, and
high blood cholesterol levels, particularly in association with LDLs, are among
the factors that contribute to an increased risk of developing atherosclerosis. Men
develop atherosclerosis more often than women, and individuals with diabetes
mellitus have a significantly higher incidence of the disease.

Certain drugs can reduce the risks associated with atherosclerosis. These
include statins, which reduce the level of cholesterol and fat in the blood, as well
as anticoagulantsand other drugs such as aspirin, which prevent formation of
blood clots. In large arteries such as the aorta or carotids, sections obstructed by
atheromas can be removed surgically and replaced with synthetic materials.
Atherosclerotic plaques can also be removed from the carotid circulation by
atherectomy, in which the fatty deposits are carefully removed by a tiny knife
inserted into the vessel via a catheter. In the case of occluded coronary arteries,
the lives of countless cardiac patients have been saved by coronary bypass
surgery, in which sections of blood vessels from other parts of the body are used
to route blood flow around the obstructions. Some occlusions can be opened
by balloon angioplasty, in which a catheter is inserted to the site of obstruction
and a balloon is inflated in order to dilate the artery and flatten the plaque deposit