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Macrovascular disease, or atherosclerosis, is the cause of more than half of all mortality in developed countries and the leading cause of death in the United States. It is a progressive disease of the large- and medium-sized arteries. The name is derived from the Greek athero meaning "gruel" or "paste" and sclerosis meaning "hardening." Thus, atherosclerosis is the hardening of the arteries due to the accumulation of this paste (commonly called plaque).

Any vessel in the body may be affected; however, the aorta, coronary, carotid, and iliac arteries are most frequently affected. When the coronary arteries are involved, it results in coronary artery disease (CAD). Hardening of the arteries is due to the build up of plaque and mineral deposits. As a result, the supply of blood to the heart is reduced, which can lead to chest pain or a myocardial infarction (heart attack). Hardening of the arteries causes an increase in resistance to blood flow and, therefore, an increase in blood pressure.

Everyone gets atherosclerosis. It is said that if every person lived to be 100 years old, each would eventually die of atherosclerosis. The process begins early in life. Therefore, physicians should obtain risk-factor profiles and a family history for children. Surgical procedures such as angioplasty and cardiac bypass may restore cardiovascular function. However, prevention is the key. Smoking, high blood cholesterol, high blood pressure, a high-fat diet, and lack of physical activity are the most serious risk factors for atherosclerosis and other cardiovascular diseases. Controlling one of these risk factors can help control the others. For example, regular exercise can help control cholesterol, blood pressure, weight, and stress levels. Smoking is the most preventable risk factor. For some, a low-dose aspirin taken daily is recommended for adults over age forty to thin the blood.

For optimal health, health professionals recommend a change to a healthful diet and lifestyle for those at risk, including daily physical activity; smoking cessation; a low-fat, low-cholesterol diet; reducing sodium intake; and managing stress.

Delores C. S. James

Internet Resource

American Heart Association. "Common Cardiovascular Diseases." Available from <http://www.americanheart.org/stroke>

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