Atherosclerosis, Arteriosclerosis, and Heart Surgery

The terms atherosclerosis and arteriosclerosis are frequently used interchangeably, as though they are the same condition, but this is not the case. While both conditions are types of coronary artery disease and may lead to the need for heart surgery, they are not the same and the treatment is very different.

Arteriosclerosis

Arteriosclerosis is the hardening of the arteries. This condition not only thickens the wall of arteries but also causes stiffness and a loss of elasticity. Over time, the arteries become harder and harder as they are slowly damaged by high blood pressure. Arteriosclerosis may be present in any artery of the body, but the disease is most concerning when it attacks the coronary arteries and threatens to cause a heart attack.

Atherosclerosis

Atherosclerosis is the most common type of arteriosclerosis, or hardening of the arteries, and caused by plaque building up in the vessel. Over time the plaque causes thickening of the walls of the artery. Stiffness and a loss of elasticity also result.

To clarify, a patient with arteriosclerosis (hardened arteries) may not have atherosclerosis (plaque), but a patient with atherosclerosis does have arteriosclerosis. Patients often have both conditions, which can cause a decrease in the blood flow to the heart muscle.

Treatments for Coronary Artery Disease

One of the key principles of treating the hardening of the arteries is to stop the progress of the disease process. The first step in preventing and treating coronary artery disease is to make lifestyle changes. Basically, do all of the things that our doctors tell us to do and we often don't bother to do. Eat a more healthful diet with an emphasis on fruits and vegetables and minimize fats and meats. Increasing fiber intake is also helpful.

Exercise regularly—this doesn't have to be strenuous exercise, it can be a 30-minute walk in the evenings. Frequency counts, so going for a brisk walk every night can be very helpful, you do not need to be running marathons to benefit greatly. Research shows that a modest reduction of weight—about 10% of excess weight—can have significant positive effects on blood pressure, diabetes, and other conditions that worsen heart disease.

Reduce stress in your life, make sure you are getting enough sleep on a regular basis, and, in general, take better care of yourself to stop the progression of heart disease or even reverse it. 

If you have a family history of severe coronary artery disease and think there is nothing you can do to change that, ask yourself this question before you decide you can't improve it: Do you have a family history of heart disease OR a shared family history of not exercising, smoking, ignoring your diabetes, eating poorly, sleeping too little, and living with too much stress? 

Medications to control cholesterol levels in the body may not improve heart disease, but it may prevent the condition from worsening over time. Diet modification is also important to prevent increasing problems.

For moderate disease, the treatment is often the placement of stents in the coronary arteries, tiny devices made to keep the arteries open enough for blood to flow to the heart. These are placed during a procedure called a cardiac catheterization, or heart cath for short. 

In severe cases, coronary artery bypass surgery, or CABG surgery, is required to ensure adequate blood flow to the heart. When coronary artery disease becomes severe, blood does not flow freely to the heart and this can cause chest pain or even a heart attack. When other treatments are ineffective, or when the problem is so severe that it must be treated immediately, the coronary artery bypass graft surgery is the treatment of choice. This procedure takes vessels from the legs and inside the chest to direct blood flow around blocked arteries so that it can flow freely to the heart. Like all open-heart surgeries, the coronary artery bypass procedure is a serious one and requires weeks to months of recovery.

Risk Factors for Atherosclerosis

Atherosclerosis is made worse by cigarette smoking, high cholesterol, being overweight and high blood pressure. Diet has a significant impact on atherosclerosis, as does a lack of exercise. Conditions such as diabetes can also increase the risk of coronary artery disease. Eliminating or controlling those factors, as well as making diet changes that decrease the amount of fat being eaten, can often halt the progression of the disease or even improve the condition. A combination of exercise, diet restrictions, and medications often decrease or stop the formation of plaque in the arteries.

A Word From Verywell

Atherosclerosis and arteriosclerosis can both benefit from lifestyle modifications. Don't be intimidated by this, consider it a challenge to improve your life one step at a time. If you can only walk for a few minutes at a time, start with the goal of increasing your activity slowly over time. Start with small diet changes, such as eliminating soda or fast food, or decreasing the quantity of processed food in the diet while increasing fiber intake. The changes do not need to be massive in order to produce major changes in your health.