Atherosclerosis and its complications, such as myocardial infarction and stroke, are major causes of morbidity and mortality. Although there are numerous chemical drugs available some drugs are not effective and some have serious side effects. Traditional Chinese medicine (TCM) has a long history for the prevention and treatment of atherosclerosis due to its less side effects and superior efficacy.
Atherosclerosis is a condition involving the narrowing of the blood vessels due to the build-up of fats, cholesterol, and other substances on the artery walls. The buildup of plaque around artery walls causes the walls to narrow and thus limits the flow of oxygen-rich blood to the body’s organs. Risk factors may include high cholesterol and triglyceride levels, high blood pressure, smoking, diabetes, obesity, physical activity, and eating saturated fats.
Coronary Artery Disease
CAD occurs when the coronary arteries become damaged or diseased due to plaque. Plaque is cholesterol containing deposits that buildup and cause the arteries to become narrow, decreasing blood flow to the heart. Over time, the decreased blood flow can cause angina with symptoms of chest pain, shortness of breath, and arrhythmias. Such chest pain can be described as pressure, heaviness, numbness, or squeezing of the chest which could be mistaken for indigestion or heartburn. Although angina is usually felt in the chest, it can also cause pain in the shoulders, arms, neck, or back.4,5 A complete blockage can cause a heart attack.
The cause of CAD is thought to begin with an injury to the inner layer endothelial cells of a coronary artery. This injury or damage could begin as early as childhood. Injury to the inner layer of the arteries can occur from smoking, high blood pressure, high cholesterol, diabetes, infections, or a sedentary lifestyle. Once the inner layer of an artery becomes damaged, plaque accumulates at the site of the injury in a process called atherosclerosis. Normal endothelium cells produce anticoagulation factors such as heparin and nitric oxide to prevent blood clotting formation. However, the injured endothelium cells produce pro-coagulant proteins and pro-inflammatory cytokines which can destabilize the plaque. If the plaque ruptures, platelets clump at the site of injury which can block the artery, leading to a heart attack.
Renovascular disease is a progressive condition due to atherosclerosis that causes narrowing or blockage of the renal arteries. As the plaque builds up, it reduces blood supply and damages the kidneys. Usually, there are no warning signs; however, as the disorder progresses, patients may experience high blood pressure and symptoms related to kidney failure. This condition is often overlooked as a cause of high blood pressure.
Peripheral Artery Disease
Atherosclerotic plaque in the arteries of the other part of the body such as the legs or arms can cause peripheral artery disease. Peripheral artery disease causes sores that heal slowly and poor leg circulation which leads to numbness and pain in the calf muscles when walking (claudication) or climbing stairs. Severe blockage of blood flow can cause tissue death and lead to leg amputation.
Erectile Dysfunction (ED) is also related to atherosclerosis. The artery blockage usually starts from the lower arteries interrupting blood flow necessary for an erection. Usually after 3-5 years of ED, patients will see heart related problems such as a heart attack or stroke. Although the cause of ED is not always linked to atherosclerosis, if patients have no obvious cause, such as trauma, screening for heart disease should be considered.