What is atheroma (atherosclerosis)?

What is Cardiovascular disease?
Cardiovascular disease (CVD) is an abnormal function of the heart or blood vessels. It can increase the risk for heart attack, heart failure, stroke, cardiac rhythm problems, thus resulting in decreased quality of life and decreased life expectancy. When doctors use the term ‘Cardiovascular Disease’ they usually mean diseases of the heart or blood vessels that are caused by atheroma.

What is atheroma (atherosclerosis)?
Patches of atheroma are small fatty lumps that develop within the inside lining of arteries (blood vessels). Atheroma is also known as ‘hardening of the arteries’. Patches of atheroma are often called ‘plaques’ of atheroma. Over months or years, patches of atheroma can become larger and thicker, making an artery narrower, which can reduce the blood flow through the artery. For example, narrowing of the coronary (heart) arteries with atheroma can cause angina.
Sometimes a blood clot (thrombosis) forms over a patch of atheroma and completely blocks the blood flow. Depending on the artery affected, this can cause a heart attack, a stroke or other serious problems.

What are the cardiovascular diseases caused by atheroma?

The cardiovascular diseases than can be caused by atheroma include :
Heart disease : The term ‘heart disease’ or ‘coronary heart disease’ is used for conditions caused by narrowing of one or more of the coronary (heart) arteries by atheroma. This can cause angina, heart attack and heart failure. Heart disease is common in people over 50 years.

Cerebro-vascular disease – stroke and TIA :
Cerebro-vascular disease means a disease of the arteries in the brain. This can lead to TIA (transient ischemic attack) or a stroke. A stroke means that part of the brain is suddenly damaged. The common cause of stroke is blocking of an artery in the brain by a blood clot (thrombus) which usually forms over some atheroma. A TIA is a disorder caused by temporary lack of blood supply to a part of the brain, resulting in weakness in part of body. If left untreated it can progress to stroke (paralysis).

Peripheral vascular disease :
Peripheral vascular disease is narrowing due to atheroma that affects arteries other than in the heart or brain. The arteries that take blood to the legs are the most commonly affected.

What are the risk factors?
Everybody has some risk of developing atheroma. However, certain ‘risk factors’ which increase the risk include.

Lifestyle risk factors that can be prevented or changed :
Lack of physical activity (a sedentary lifestyle)
An unhealthy diet and eating too much salt.
Excessive alcohol intake
Treatable or partly treatable risk factors :
Hypertension (high blood pressure)
High cholesterol
High triglyceride
Kidney diseases

Fixed risk factors – ones that you cannot alter :
A strong family history a father or brother who developed heart disease or a stroke before they were 55, or a mother or sister who developed heart disease or a stroke before they were 65.
Being male
An early menopause in women.
Age. The older you become, the more likely you are to develop atheroma.
Ethnic group. For example, people who live in the Uk with ancestry from India, Pakistan, Bangladesh or Sri Lanka have an increased risk.
If you have a fix risk factor, you can make an extra efforts to tackle any lifestyle risk factors that can be changed.

Assessing your cardiovascular health risk.
The following people should be assessed to find their cardiovascular health risk :
All adults aged 40 or more.
Adults or any age who have.
A strong family history of early cardiovascular disease.
A first degree relative (parent, brother, sister, child) with a serious hereditary lipid disorder. For example, familial hypercholesterolemia or familial combined hyperlipidaemia.
Obese and over weight adults having a BMI of over 23.

What does the assessment involve?

A Doctor will advise a blood test to check your cholesterol and glucose (sugar) level.
Measure your blood pressure and your weight.
Ask you, if you smoke.
Ask, if there is a history of cardiovascular disease in your family. If so, at what age the disease started in the affected family members.
A score is calculated based on these factors plus your age and your sex. An adjustment to the score is made for certain other factors such as strong family history and ethnic origin.

What does the assessment score mean?
You are given a score as a % chance. For example, if your score is 30% this means that you have a 30% chance of developing a cardiovascular disease within the next 10 years. This is the same as saying a 30 in 100 chance (or a 3 in 10 chance). In other words, in this example, 3 in 10 people with the same score that you have will develop a cardiovascular disease within the next 10 years.
Note : the score cannot say if you will be one of the three. It cannot predict what will happen to each individual person. It just gives you the odds.

You are said to have a :

High risk – If your score is 20% or more. That is, in 10 chance or more of developing a cardiovascular disease within the next 10 years.
Moderate risk – If your score is 10-20%. That is, between 1 in 10 and 2 in 10 chance.
Low risk – If your score is less than 10%. That is, less than 1 in 10 chance.

Who should be treated to reduce their cardiovascular health risk?
Treatment to reduce the risk of developing a cardiovascular disease is usually offered to the people with :
Risk assessment score of 20% of more
An existing cardiovascular disease (to lower the chance of it getting worse or of developing a further disease)
Diabetes, if you have diabetes, the time that treatment is started to reduce cardiovascular risk depends on factors such as: your age, how long you have had diabetes, your blood pressure and if you have any complications of diabetes.

Will losing weight help prevent or improve your conditions and its complications?
The increased health risk of obesity is most marked when the excess fat is mainly in the abdomen rather than on the hips and thighs. Asians are prone to Metabolic Syndrome, with a high risk for developing diabetes and subsequently heart disease and stroke. A waist measurement of 90 cm or above for (Asian) men and 80 cm or above for (asian) women is a significant health risk. If you are obese or overweight you can greatly reduce you health risk by losing 5 – 10% of your weight. This is often about 5-10 kg.

How Unani experts can help you manage your condition?

Unani experts can help you to manage this condition by helping you to lose weight and advising appropriate changes in diet and lifestyle. Diet plan for clients with/at risk of heart problems takes into consideration a balanced diet approach focusing on consumption of fruits & vegetables, whole grains, non fat dairy products, lean meat, fish and low in saturated fat, total fat and refined carbohydrates. Diet counselor act as transient support system to prepare & motivate clients to incorporate gradual changes. Unani counselor advise behaviour and lifestyle modification to reduce both weight as well as waist circumference. Regular physical activity helps in energy expenditure and also reduces your risk of having a heart attack or stroke. The physiotherapists, fitness experts & counselors at Unani plan an exercise program comprising both active and passive exercise as per your lifestyle, fitness level and health conditions.