atherosclerosis atherosclerosis atherosclerosis is a pattern of the disease arteriosclerosis in which the wall of the artery develops abnormalities, called lesions. these lesions may lead to narrowing due to the buildup of atheromatous plaque. at onset there are usually no symptoms, but if they develop, symptoms generally begin around middle age. when severe, it can result in coronary artery disease, stroke, peripheral artery disease, or kidney problems, depending on which arteries are affected. not to be confused with arteriosclerosis. atherosclerosisother namesarteriosclerotic vascular disease (asvd)the progression of atherosclerosis (narrowing exaggerated)specialtycardiology, angiologysymptomsnonecomplicationscoronary artery disease, stroke, peripheral artery disease, kidney problemsusual onsetyouth (worsens with age)causesunknownrisk factorshigh blood pressure, diabetes, smoking, obesity, family history, unhealthy diet (notably trans fat), chronic vitamin c deficiencypreventionhealthy diet, exercise, not smoking, maintaining a normal weightmedicationstatins, blood pressure medication, aspirinfrequency≈100% (>65 years old) the exact cause is not known and is proposed to be multifactorial. risk factors include abnormal cholesterol levels, elevated levels of inflammatory markers, high blood pressure, diabetes, smoking, obesity, family history, genetic, and an unhealthy diet. plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. the narrowing of arteries limits the flow of oxygen-rich blood to parts of the body. diagnosis is based upon a physical exam, electrocardiogram, and exercise stress test, among others. prevention is generally by eating a healthy diet, exercising, not smoking, and maintaining a normal weight. treatment of established disease may include medications to lower cholesterol such as statins, blood pressure medication, or medications that decrease clotting, such as aspirin. a number of procedures may also be carried out such as percutaneous coronary intervention, coronary artery bypass graft, or carotid endarterectomy. atherosclerosis generally starts when a person is young and worsens with age. almost all people are affected to some degree by the age of 65. it is the number one cause of death and disability in the developed world. though it was first described in 1575, there is evidence that the condition occurred in people more than 5,000 years ago. signs and symptoms atherosclerosis is asymptomatic for decades because the arteries enlarge at all plaque locations, thus there is no effect on blood flow. even most plaque ruptures do not produce symptoms until enough narrowing or closure of an artery, due to clots, occurs. signs and symptoms only occur after severe narrowing or closure impedes blood flow to different organs enough to induce symptoms. most of the time, patients realize that they have the disease only when they experience other cardiovascular disorders such as stroke or heart attack. these symptoms, however, still vary depending on which artery or organ is affected. abnormalities associated with atherosclerosis begin in childhood. fibrous and gelatinous lesions have been observed in the coronary arteries of children aged 6–10. fatty streaks have been observed in the coronary arteries of juveniles aged 11–15, though they appear at a much younger age within the aorta. clinically, given enlargement of the arteries for decades, symptomatic atherosclerosis is typically associated with men in their 40s and women in their 50s to 60s. sub-clinically, the disease begins to appear in childhood and rarely is already present at birth. noticeable signs can begin developing at puberty. though symptoms are rarely exhibited in children, early screening of children for cardiovascular diseases could be beneficial to both the child and his/her relatives. while coronary artery disease is more prevalent in men than women, atherosclerosis of the cerebral arteries and strokes equally affect both sexes. marked narrowing in the coronary arteries, which are responsible for bringing oxygenated blood to the heart, can produce symptoms such as chest pain of angina and shortness of breath, sweating, nausea, dizziness or light-headedness, breathlessness or palpitations. abnormal heart rhythms called arrhythmias—the heart beating either too slowly or too quickly—are another consequence of ischemia. carotid arteries supply blood to the brain and neck. marked narrowing of the carotid arteries can present with symptoms such as: a feeling of weakness; being unable to think straight; difficulty speaking; dizziness; difficulty in walking or standing up straight; blurred vision; numbness of the face, arms and legs; severe headache; and loss of consciousness. these symptoms are also related to stroke (death of brain cells). stroke is caused by marked narrowing or closure of arteries going to the brain; lack of adequate blood supply leads to the death of the cells of the affected tissue. peripheral arteries, which supply blood to the legs, arms and pelvis, also experience marked narrowing due to plaque rupture and clots. symptoms of the narrowing are numbness within the arms or legs, as well as pain. another significant location for plaque formation is the renal arteries, which supply blood to the kidneys. plaque occurrence and accumulation lead to decreased kidney blood flow and chronic kidney disease, which, like in all other areas, is typically asymptomatic until late stages. according to united states data for 2004, in about 66% of men and 47% of women, the first symptom of atherosclerotic cardiovascular disease is a heart attack or sudden cardiac death (death within one hour of onset of the symptom). cardiac stress testing, traditionally the most commonly performed non-invasive testing method for blood flow limitations, in general, detects only lumen narrowing of ≈75% or greater, although some physicians claim that nuclear stress methods can detect as little as 50%. case studies have included autopsies of u.s. soldiers killed in world war ii and the korean war. a much-cited report involved the autopsies of 300 u.s. soldiers killed in korea. although the average age of the men was 22.1 years, 77.3 percent had "gross evidence of coronary arteriosclerosis". other studies done of soldiers in the vietnam war showed similar results, although often worse than the ones from the earlier wars. theories include high rates of tobacco use and (in the case of the vietnam soldiers) the advent of processed foods after world war ii. risk factors