{"id":18,"date":"2025-09-27T22:48:32","date_gmt":"2025-09-27T22:48:32","guid":{"rendered":"https:\/\/cmcdeploytwo.co.nz\/vsoanz\/?page_id=18"},"modified":"2025-09-27T23:31:21","modified_gmt":"2025-09-27T23:31:21","slug":"atherosclerosis","status":"publish","type":"page","link":"https:\/\/cmcdeploytwo.co.nz\/vsoanz\/index.php\/atherosclerosis\/","title":{"rendered":"Atherosclerosis"},"content":{"rendered":"<div class=\"wpb-content-wrapper\">[vc_row full_width=&#8221;stretch_row&#8221; content_placement=&#8221;middle&#8221; equal_height=&#8221;yes&#8221; rtl_reverse=&#8221;yes&#8221; remove_bottom_col_margin=&#8221;true&#8221; columns_right=&#8221;yes&#8221; wpex_bg_color=&#8221;#03a3de&#8221; min_height=&#8221;350px&#8221;][vc_column width=&#8221;1\/2&#8243;]<style>.vcex-image.vcex_69d07518a09e7 .vcex-image-img{object-position:right top;}<\/style><figure class=\"vcex-image vcex-module vcex-fill-column vcex_69d07518a09e7\"><div class=\"vcex-image-inner wpex-relative wpex-w-100 vc_custom_1759015831619\"><img width=\"1210\" height=\"657\" src=\"https:\/\/cmcdeploytwo.co.nz\/vsoanz\/wp-content\/uploads\/2025\/09\/Atherosclerosis.webp\" class=\"vcex-image-img wpex-align-middle wpex-w-100\" alt=\"\" loading=\"lazy\" decoding=\"async\" srcset=\"https:\/\/cmcdeploytwo.co.nz\/vsoanz\/wp-content\/uploads\/2025\/09\/Atherosclerosis.webp 1210w, https:\/\/cmcdeploytwo.co.nz\/vsoanz\/wp-content\/uploads\/2025\/09\/Atherosclerosis-300x163.webp 300w, https:\/\/cmcdeploytwo.co.nz\/vsoanz\/wp-content\/uploads\/2025\/09\/Atherosclerosis-1024x556.webp 1024w, https:\/\/cmcdeploytwo.co.nz\/vsoanz\/wp-content\/uploads\/2025\/09\/Atherosclerosis-768x417.webp 768w\" sizes=\"auto, (max-width: 1210px) 100vw, 1210px\" \/><\/div><\/figure>[\/vc_column][vc_column width=&#8221;1\/2&#8243;][vc_column_text css=&#8221;.vc_custom_1759015853663{padding-top: 20px !important;padding-bottom: 20px !important;}&#8221; color=&#8221;#fefefe&#8221;]\n<h1><strong>Atherosclerosis<\/strong><br \/>\nHardening of the Arteries<\/h1>\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1759015527111{margin-top: 60px !important;}&#8221;][vc_column][vc_tta_tour controls_size=&#8221;md&#8221; active_section=&#8221;1&#8243;][vc_tta_section title=&#8221;What is hardening of the arteries?&#8221; tab_id=&#8221;1759012899351-dcaaabe1-cd5c&#8221;][vc_column_text css=&#8221;&#8221;]\n<h2 class=\"wp-block-heading\">What is hardening of the arteries?<\/h2>\n<p>Hardening of the arteries (or atherosclerosis) is a degenerative disease of large and medium sized arteries.\u00a0 Inflammation seems to have an increasingly important role in the process, in which immune mechanisms interact with metabolic factors.\u00a0 This influences the initiation, propagation and activation of atherosclerotic lesions within the arteries (Hansson GK, 2005).<\/p>\n<p>The intima (or innermost layer of the artery) becomes thickened by the development of fibrous tissue and the accumulation of lipid (fat).\u00a0 Although the arteries become progressively damaged over many years, the initial changes can occur in early adulthood (20-30yrs).\u00a0 Hardening of the arteries is not an inevitable result of ageing, but it is more common in the elderly.<\/p>\n<p>The normal artery consists of three layers.\u00a0 The intima or inner layer is the surface in contact with flowing blood.\u00a0 A single layer of cells (endothelial cells) lines the whole of the arterial (and venous) system.\u00a0 It is a highly complex and important layer.\u00a0 It is these cells which interact with flowing blood.\u00a0 These cells are not simply a passive lining, but are crucial cells involved in wound healing, inflammation, blood clotting and immunity. These cells are supported by a matrix of thin tissue.\u00a0 Under this matrix is the middle layer (or media) consisting of muscle cells which can cause an artery to constrict or dilate. The outer layer (or adventitia) is mainly fibrous tissue.\u00a0 A normal artery is very soft, pliable and elastic.<\/p>\n<p>The initial trigger for the development of hardening of the arteries is probably damage to the endothelial cell layer lining the artery.\u00a0 This damage may be caused by smoking, viruses, chemicals and drugs.\u00a0 There may be many chemical causes of damage to the endothelial cells in our environment that have not been identified.\u00a0 In the earliest stages, yellow fatty streaks develop in the blood vessels caused by the deposition of fats in the wall of the artery.\u00a0 They are yellow due to the deposited cholesterol.\u00a0 Fatty streaks will not cause any symptoms, but are the earliest sign of arterial disease and can progress to the development of atherosclerotic plaques.\u00a0 Plaques are basically thickening of the innermost layer of the arterial wall. As the plaques become larger they impede blood flow through the artery.<\/p>\n<p>Plaques are caused by the accumulation of low density lipoprotein (LDL, a type of cholesterol). Raised levels of LDL in the blood stream lead to the transport of this excess LDL into the artery wall where it is retained.\u00a0 This LDL is then chemically altered (lipid peroxidation) and as more is retained a massive accumulation of cholesterol develops (foam cells).\u00a0 Other cells (monocytes) are attracted towards this altered LDL by inflammatory chemical compounds and accelerate the accumulation of further LDL.\u00a0 A fibrous plaque develops as smooth muscle cells and monocytes accumulate.\u00a0Monocytes are also prevented from leaving the early forming plaque by certain chemicals. The monocytes transform into another cell type called macrophages which absorb the cholesterol and fats deposited in the arterial wall.\u00a0 The macrophages become swollen with cholesterol and become foam cells (Gerstzen RE and Tager AM, 2012). The plaques can become so thick that they protrude into the artery and can interfere with normal blood flow.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignright size-full wp-image-19\" src=\"https:\/\/cmcdeploytwo.co.nz\/vsoanz\/wp-content\/uploads\/2025\/09\/Endo_dysfunction_Athero-1.png\" alt=\"\" width=\"429\" height=\"439\" srcset=\"https:\/\/cmcdeploytwo.co.nz\/vsoanz\/wp-content\/uploads\/2025\/09\/Endo_dysfunction_Athero-1.png 429w, https:\/\/cmcdeploytwo.co.nz\/vsoanz\/wp-content\/uploads\/2025\/09\/Endo_dysfunction_Athero-1-293x300.png 293w\" sizes=\"auto, (max-width: 429px) 100vw, 429px\" \/>Complicated plaques develop if the plaque surface becomes damaged (ulceration) and this can cause fragments of the plaque to break away into the blood vessel and be carried downstream to block a smaller blood vessel \u2013 a process called embolisation. In more advanced cases calcium is also deposited and the plaques become very hard.\u00a0 These plaques may grow so large that they obstruct the flow of blood through the blood vessel or they may fracture and blood can be forced underneath the plaque, pushing it further into the blood vessel.\u00a0 When an artery becomes blocked by hardening of the arteries blood is diverted into smaller arteries (collaterals).\u00a0 These smaller arteries can maintain a blood supply to an area even when the main artery has been blocked.<\/p>\n<p>As the disease worsens the arteries literally become harder and lose their elasticity or stretchiness.<\/p>\n<p>For a more detailed, but technical description of the mechanisms behind the development of atherosclerosis see\u00a0<a href=\"http:\/\/circ.ahajournals.org\/content\/91\/9\/2488.full\" target=\"_blank\" rel=\"noreferrer noopener\">JA Berliner et al, 1995<\/a>[\/vc_column_text][\/vc_tta_section][vc_tta_section title=&#8221;Why do some people develop hardening of the arteries?&#8221; tab_id=&#8221;1759012899354-da1d8fff-c098&#8243;][vc_column_text css=&#8221;&#8221;]\n<h2 class=\"wp-block-heading\">Why do some people develop hardening of the arteries?<\/h2>\n<p>There are many factors associated with hardening of the arteries, but there are only 4 or 5 which can be manipulated \u2013 smoking, high blood pressure, high cholesterol levels, presence of diabetes, and exercise.<\/p>\n<p>In some people there is a clear hereditary factor.\u00a0 In other words other members of the family will have suffered with atherosclerosis at an early age.\u00a0 This may be due to risk factors that we have not yet discovered, but it can also be due to inherited diseases of cholesterol metabolism.\u00a0 If you are a man, you have more risk of developing hardening of the arteries.<\/p>\n<p>It is often a combination of factors that is important.\u00a0 High blood pressure alone carries risks, but if there are high cholesterol levels also and a family history of atherosclerosis, the risks will be much greater.<\/p>\n<p>In recent years certain types of infection (Chlamydia pneumoniae) have been implicated in atherosclerosis.\u00a0 No definitive link between infection and atherosclerosis has been established, but it is an area of ongoing research.[\/vc_column_text][\/vc_tta_section][vc_tta_section title=&#8221;What problems can hardening of the arteries cause?&#8221; tab_id=&#8221;1759014772115-45b909ba-0338&#8243;][vc_column_text css=&#8221;&#8221;]\n<h2 class=\"wp-block-heading\">What problems can hardening of the arteries cause?<\/h2>\n<p>Hardening of the arteries causes two major types of problems in the arteries.\u00a0 Firstly, it may cause swelling \/dilatation of the arteries to form\u00a0<a href=\"https:\/\/vascular-society.nz\/aortic-aneurysm\/\" target=\"_blank\" rel=\"noreferrer noopener\" data-type=\"page\" data-id=\"43\">aneurysms<\/a>. Aneurysms can ultimately either rupture and bleed or they may accumulate large amounts of blood clot and either block or send showers of tiny clots into smaller arteries downstream (embolisation).<\/p>\n<p>Secondly, hardening of the arteries causes the artery to narrow or block off completely. If an artery is narrowed or blocked then the effects of this will depend on which artery is affected.\u00a0 If the arteries to the legs are affected, then this can cause\u00a0<a href=\"https:\/\/vascular-society.nz\/intermittent-claudication-pvd\/\" target=\"_blank\" rel=\"noreferrer noopener\" data-type=\"page\" data-id=\"113\">intermittent claudication<\/a>\u00a0\u2013 a pain in the legs on exercising.<\/p>\n<p>If the arteries to the brain are affected then this can cause a\u00a0<a href=\"https:\/\/vascular-society.nz\/stroke-tia-endarterectomy\/\" target=\"_blank\" rel=\"noreferrer noopener\" data-type=\"page\" data-id=\"107\">stroke<\/a>.\u00a0 If arteries to a part of the brain are blocked then this part of the brain dies.\u00a0 If this part of the brain controls movement of the right arm, then paralysis of the right arm will result.<\/p>\n<p>If the arteries to the heart are affected this can cause angina (chest pain) or a heart attack.\u00a0 In the kidneys hardening of the arteries can cause kidney failure and high blood pressure (hypertension).[\/vc_column_text][\/vc_tta_section][vc_tta_section title=&#8221;Can hardening of the arteries be cured?&#8221; tab_id=&#8221;1759014806183-f54d1997-de0b&#8221;][vc_column_text css=&#8221;&#8221;]\n<h2 class=\"wp-block-heading\">Can hardening of the arteries be cured?<\/h2>\n<p>No. Hardening of the arteries cannot be cured at present.<\/p>\n<p>The symptoms that are caused by hardening of the arteries can sometimes be treated.\u00a0 For instance carotid endarterectomy is an operation to fix the damage caused by hardening of the carotid arteries in the neck.\u00a0 The carotid arteries take blood to the brain.<\/p>\n<p>Angioplasty can be used in some circumstances to treat the symptoms caused by hardening of the arteries particularly in the arteries to the legs and to the heart.\u00a0 Angioplasty does not affect the underlying atherosclerotic processes\u00a0 \u2013 it is purely a mechanical method of re-opening the blood vessel.\u00a0 This point is often forgotten. Angioplasty and bypass surgery do not alter the development of atherosclerosis.\u00a0 This is a similar situation to calcium scale which can develop on kettles and pipes in areas which have hard water (containing calcium). The scale can be removed and allow the pipes to function again, but they will fur up again if the water is not altered, as the underlying cause has not been addressed.\u00a0 Coronary artery bypass surgery is used to improve the blood flow to the heart when patients have angina or have had a previous heart attack.\u00a0 Similar sorts of\u00a0<a href=\"https:\/\/vascular-society.nz\/lower-limb-bypass-surgery\/\" target=\"_blank\" rel=\"noreferrer noopener\" data-type=\"page\" data-id=\"111\">bypass surgery<\/a>\u00a0can be used to treat blockages in the legs.<\/p>\n<p>The factors that lead to the development of hardening of the arteries can be altered.\u00a0 Controlling these vascular risk factors is important because it can help to reduce the risk of further problems caused by hardening of the arteries.[\/vc_column_text][\/vc_tta_section][vc_tta_section title=&#8221;What can be done to reduce the risk of developing problems?&#8221; tab_id=&#8221;1759014827533-6ef99622-00a9&#8243;][vc_column_text css=&#8221;&#8221;]\n<h2 class=\"wp-block-heading\">What can be done to reduce the risk of developing problems?<\/h2>\n<p><strong>1. Smoking<\/strong><\/p>\n<p>Smoking is the most important factor.\u00a0 If you smoke and have problems with your arteries you should stop immediately.\u00a0 This can be difficult.\u00a0 Smoking is physically and mentally addictive.\u00a0 If you stop smoking you will not always feel the benefits immediately \u2013 it takes time.\u00a0 There are many ways in which you can be helped to stop smoking by your own general practitioner.\u00a0 These include nicotine patches, drugs and continuing support.\u00a0 The most important factor in quitting tobacco is actually wanting to stop. If you live in a house with another smoker it can be especially difficult to quit and a team effort is likely to be needed.<\/p>\n<p><strong>2. High blood pressure<\/strong><\/p>\n<p>If you have high blood pressure this should be treated as this reduces the risk of further arterial problems.\u00a0 Exercise and possibly dietary salt restriction may be helpful in maintaining a normal blood pressure. The individual benefits of treating blood pressure are of a similar order to treating cholesterol (see below).<\/p>\n<p><strong>3. Cholesterol<\/strong><\/p>\n<p>If your cholesterol level is high this should be lowered.\u00a0 A low fat diet can help, but you may need tablets to keep cholesterol levels low.\u00a0 Several beneficial effects of lipid lowering drugs may be due to their anti-inflammatory properties.\u00a0 Although lowering cholesterol levels is clearly helpful the potential benefits to any individual patient are actually very small. Exercise can also be helpful in lowering cholesterol levels.<\/p>\n<p>A recent analysis of 14 trials involving over 90,000 patients has reported on the actual benefits from cholesterol lowering therapy (<a href=\"http:\/\/www.lipidgeneticsclinic.ca\/Documents\/pdf\/2005%20Lipid%20trialists%20Lancet.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">CTT Collaborators, 2005<\/a>).\u00a0 The risk of dying can be reduced from 9.7% (9 to 10 chances in 100) over the periods studied down to 8.5% (8-9 chances in 100).\u00a0 Essentially this means that 98-99 people in every 100 people on a cholesterol lowering drug will not live longer, and the drug will not reduce their risk of dying.\u00a0 There are slightly greater reductions in risk of having heart attacks, but less benefits in terms of reduction of stroke risk.\u00a0 The same sort of benefit is seen with interventions such as for blood pressure lowering.\u00a0 When patients start these, frequently lifelong, medications it is often not made clear that the individual benefits are extremely small.<\/p>\n<p>The\u00a0<a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/17398372\" target=\"_blank\" rel=\"noreferrer noopener\">Heart protection study<\/a>\u00a0examined the effect of simvastatin on reducing the risk of major vascular events (stroke, heart attack), but not mortality.\u00a0 There is more benefit in patients with peripheral vascular disease (PVD).\u00a0 There was a reduction in major vascular events in patients with PVD of 6.3% (from 32.7% to 26.4%).\u00a0 Definitely beneficial treatment but 93% of patients who use simvastatin in these circumstances will still have no benefit.<\/p>\n<p>The\u00a0<a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/18191683\" target=\"_blank\" rel=\"noreferrer noopener\">CTT collaborators also examined the effect of cholesterol lowering treatment in patients with diabetes<\/a>. The overall risk of death in patients with diabetes was reduced by taking cholesterol lowering treatment from 11.9% to 11.0%.\u00a0 A reduction of 0.9%. Less than 1 in 100 patients will live longer on this treatment. There was a greater reduction in any vascular event (stroke, heart attack or heart operation) from 19.2% to 15.6%. A reduction of 3.6%. Less than 4 patients in 100 will benefit.<\/p>\n<p>Another way of looking at treatment is the number of tablets it would take to save one life. In the 4S (<a href=\"http:\/\/www.fmhs.auckland.ac.nz\/sms\/pharmacology\/holford\/teaching\/humanbio355\/_docs\/lancet_simvastatin_scandinavian_survival_study_1994.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">4S, 1994<\/a>) trial of cholesterol reduction over 59,000 tablets would have to be taken to prevent one death. An interesting perspective on risk reduction can be found\u00a0<a href=\"http:\/\/www.bmj.com\/content\/316\/7149\/1956.pdf+html\" target=\"_blank\" rel=\"noreferrer noopener\">in this article published in the British Medical Journal<\/a>.<\/p>\n<p><strong>4. Diabetes<\/strong><\/p>\n<p>If you have sugar diabetes (diabetes mellitus) this can be treated with insulin, tablets and sometimes diet alone to maintain a normal blood sugar.\u00a0 Diabetes has been known to cause hardening of the arteries for a long time.\u00a0 It can cause particularly severe calcium deposits in the blood vessels.\u00a0 Controlling diabetes with insulin, diet and tablets can reduce the chances of arterial disease developing or progressing, but here again the evidence from trials is that the benefit is relatively small.<\/p>\n<p><strong>5. Exercise<\/strong><\/p>\n<p>Regular exercise can help to lower cholesterol levels as well as improve exercise tolerance and general well being. It is generally recommended that exercise needs to take place for 20 minutes, 3 times week.\u00a0 The exercise needs to increase the heart rate to be beneficial.\u00a0 If you have not exercised for some time it is important to build up your exercise regime very gradually. It may take 6-8 weeks before you start to notice real benefits in fitness and wellbeing. A recent study from Australia indicated that watching TV can be detrimental to life expectancy and this effect is almost certainly mediated though the fact that prolonged hours watching television reduces exercise whilst food intake will continue whilst inactive..<\/p>\n<p><strong>6. Drugs<\/strong><\/p>\n<p>There are no specific drugs that will cure atherosclerosis, but taking a small dose of aspirin (75mgs) daily, if you have had previous problems with your arteries, can be helpful in preventing further problems.\u00a0 A recent overview summarised data from over 9000 patients in 42 trials and concluded that aspirin provided a\u00a0<strong>relative<\/strong>\u00a0risk reduction of 23% in the risk of cardiovascular events (stroke and heart attack) and cardiovascular death (<a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/15944615\" target=\"_blank\" rel=\"noreferrer noopener\">Hackam DG, 2005<\/a>).\u00a0 The\u00a0<strong>absolute<\/strong>\u00a0benefit is much smaller and in the range of 2% \u2013 4%.\u00a0 This means that only between 2 and 4 people in every 100 taking aspirin will have any benefit.\u00a0 The other 96-98 out of every 100 who take the drug do not benefit.<\/p>\n<p>Aspirin should be avoided if you have had previous problems with stomach ulcers or duodenal ulcers.<\/p>\n<p>Clopidogrel is a more expensive alternative for patients intolerant of aspirin.\u00a0 It has no major advantages over aspirin and a recent study has not demonstrated any advantage when taken with aspirin (<a href=\"http:\/\/www.cchil.org\/hospitalmedicine\/images\/resources\/091308-043057pm-1706.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">CHARISMA Investigators, 2006<\/a>).<\/p>\n<p>Dipyridamole, another antiplatelet drug, but working through a different mechanism to aspirin, has shown a small benefit if combined with aspirin when compared with aspirin alone (<a href=\"http:\/\/www.medicine.wisc.edu\/~williams\/aspirin_dipyridamole_stroke_trial.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">ESPRIT study group, 2006<\/a>) but many more patients need to stop the combination due to side effects.\u00a0 It has been estimated that adding dipyridamole to aspirin would prevent about 10 extra vascular events per 1000 patients treated (<a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC1857795\/\" target=\"_blank\" rel=\"noreferrer noopener\">Sudlow 2007<\/a>).\u00a0 Alternatively 990 patients out of every 1000 taking dipyridamole in addition to aspirin would do so with no benefit.<\/p>\n<p>Adding warfarin (another oral blood thinning drug) treatment to aspirin was also of no overall benefit over a 35 month follow up period and carried an increased risk in terms of life threatening bleeding (<a href=\"http:\/\/www.nejm.org\/doi\/pdf\/10.1056\/NEJMoa065959\" target=\"_blank\" rel=\"noreferrer noopener\">The warfarin antiplatelet vascular evaluation trial investigators, 2007<\/a>).[\/vc_column_text][\/vc_tta_section][vc_tta_section title=&#8221;Primary prevention&#8221; tab_id=&#8221;1759014855534-cd1bf395-e355&#8243;][vc_column_text css=&#8221;&#8221;]\n<h2 class=\"wp-block-heading\">Primary prevention<\/h2>\n<p>The treatments and benefits described above are examples of how patients can be treated when they have suffered a vascular event such as a heart attack or stroke or suffer with claudication pains in their legs.\u00a0 When they have established vascular disease and are being treated with preventive therapies this is described as secondary prevention.\u00a0 Primary prevention is treating patients for vascular risk factors before they develop vascular diseases.\u00a0 Unfortunately, although an attractive concept, primary prevention has even less (if any) benefits than secondary prevention.\u00a0 For instance in a study of aspirin 99.94% of patients would not benefit from treatment even though the effect of aspirin on the 0.06% of patients was shown to be highly statistically significant (<a href=\"http:\/\/researchonline.lshtm.ac.uk\/19177\/1\/mmc1.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">ATT Collaboration<\/a>).<\/p>\n<p>In the\u00a0<a href=\"http:\/\/www.courses.ahc.umn.edu\/pharmacy\/5822\/WOSCOPSTrial.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">West of Scotland cholesterol lowering study<\/a>\u00a0200 men without any previous heart disease would have to swallow over 357,000tablets (yes, that\u2019s correct) over five years to save one of them from dying from coronary heart disease<\/p>\n<p>In other studies (<a href=\"http:\/\/jama.jamanetwork.com\/article.aspx?articleid=185471\" target=\"_blank\" rel=\"noreferrer noopener\">Fowkes et al 2010<\/a>,\u00a0<a href=\"http:\/\/www.bmj.com\/content\/337\/bmj.a1840.pdf+html\" target=\"_blank\" rel=\"noreferrer noopener\">Belch et al 2008<\/a>) patients were identified as having hardening of the arteries after measurement of their ankle-brachial index. These patients had no history of vascular disease and they were then randomised to treatment with aspirin or a sugar pill (placebo) to see if aspirin was beneficial in reducing the future risk of cardiovascular events. One trial also looked at the use of antioxidants (Vitamin C, zinc sulphate, sodium selenite, alpha tocopherol, pyridoxine hydrochloride, nicotinamide and lecithin). Despite being a large well conducted studies there was no benefit in taking aspirin or antiooxidants in patients without previous cardiovascular disease.[\/vc_column_text][\/vc_tta_section][vc_tta_section title=&#8221;Latest news&#8221; tab_id=&#8221;1759014887716-648cb14b-0019&#8243;][vc_column_text css=&#8221;&#8221;]\n<h2 class=\"wp-block-heading\">Latest news<\/h2>\n<p>An article (<a href=\"http:\/\/www.bmj.com\/content\/326\/7404\/1419.pdf+html\" target=\"_blank\" rel=\"noreferrer noopener\">Wald and Law<\/a>) in the British Medical Journal has suggested that producing a Polypill could reduce heart problems by 88%.\u00a0 The authors estimate that one third of patients taking this pill from age 55 would benefit, gaining on average 11 years of life free from heart problems or stroke.\u00a0 Because hardening of the arteries usually affects all arteries in the body to some degree, the Polypill strategy would be just as likely to reduce problems caused by hardening of the arteries in the legs.<\/p>\n<p>The ingredients of the Polypill are drugs in common use today. They are:<\/p>\n<ul>\n<li>a statin (to lower cholesterol)<\/li>\n<li>a thiazide diuretic, a beta blocker and an angiotensin converting enzyme (ACE) inhibitor (to lower blood pressure)<\/li>\n<li>folic acid (to reduce homocysteine)<\/li>\n<li>aspirin (to reduce blood clotting)<\/li>\n<\/ul>\n<p>At present this combination is only a suggestion and the formulation would need to be thoroughly tested. However, these drugs already have a proven track record.\u00a0 The recent Indian Polycap study examined the feasibility of using a \u201cpolypill\u201d.\u00a0 The study looked at patients over a 12 week period and did find a reduction in blood pressure.\u00a0 No further benefits could be demonstrated in a short study. This proposal is being actively developed further and has potential, although the absolute benefits for any given individual are still likely to be small. In addition there is little incentive for the pharmaceutical industry to invest in studies as these medications are off patent.[\/vc_column_text][\/vc_tta_section][vc_tta_section title=&#8221;Useful links&#8221; tab_id=&#8221;1759014929506-4e94bf49-783d&#8221;][vc_column_text css=&#8221;&#8221;]\n<h2 class=\"wp-block-heading\">Useful links<\/h2>\n<p><a href=\"https:\/\/en.wikipedia.org\/wiki\/Atherosclerosis\" target=\"_blank\" rel=\"noopener\">http:\/\/en.wikipedia.org\/wiki\/Atherosclerosis<\/a>[\/vc_column_text][\/vc_tta_section][vc_tta_section title=&#8221;References&#8221; tab_id=&#8221;1759015003224-6e58c0d1-e0df&#8221;][vc_column_text css=&#8221;&#8221;]\n<h2>References<\/h2>\n<p><a href=\"http:\/\/circ.ahajournals.org\/content\/91\/9\/2488.full\" target=\"_blank\" rel=\"noreferrer noopener\">Berliner JA, Navab M, Fogelman AM et al. Atherosclerosis: basic mechanisms. Oxidation, inflammation and genetics.<\/a>\u00a0Circulation 1995; 91: 2488-2496.<br \/>\n<a href=\"http:\/\/vtcardsfellows.com\/pdf\/Guidelines\/Reviewarticles\/Mechanism_of_Diease_Atherosclerosis_and_CAD.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Hansson GK. Inflammation, atherosclerosis, and coronary artery disease.<\/a>\u00a0New Engl J Med 2005; 352: 1685-95.<br \/>\n<a href=\"http:\/\/211.144.68.84:9998\/91keshi\/Public\/File\/35\/366-18\/pdf\/nejmcibr1200164.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Gerszten RE, Tager AM.The Monocyte in Atherosclerosis \u2014 Should I Stay or Should I Go Now?<\/a>\u00a0New Engl J Med 2012; 366: 1734-1736.<br \/>\n<a href=\"http:\/\/www.bmj.com\/content\/326\/7404\/1419.pdf+html\" target=\"_blank\" rel=\"noreferrer noopener\">Wald NJ, Law MR. A strategy to reduce cardiovascular disease by more than 80%.<\/a>\u00a0Brit Med J 2003; 326: 1419-1423.<br \/>\n<a href=\"http:\/\/www.lipidgeneticsclinic.ca\/Documents\/pdf\/2005%20Lipid%20trialists%20Lancet.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Cholesterol Treatment Trialists\u2019 (CTT) Collaborators.\u00a0 Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins.<\/a>\u00a0Lancet 2005; 366: 1267-78.<br \/>\n<a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/17398372\" target=\"_blank\" rel=\"noreferrer noopener\">Heart Protection Study Collaborative Group. 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Television viewing time and reduced life expectancy: a life table analysis.<\/a>\u00a0J Sports Med 2011: published online first.[\/vc_column_text][\/vc_tta_section][\/vc_tta_tour][\/vc_column][\/vc_row]\n<\/div>","protected":false},"excerpt":{"rendered":"<p>[vc_row full_width=&#8221;stretch_row&#8221; content_placement=&#8221;middle&#8221; equal_height=&#8221;yes&#8221; rtl_reverse=&#8221;yes&#8221; remove_bottom_col_margin=&#8221;true&#8221; columns_right=&#8221;yes&#8221; wpex_bg_color=&#8221;#03a3de&#8221; min_height=&#8221;350px&#8221;][vc_column width=&#8221;1\/2&#8243;][\/vc_column][vc_column width=&#8221;1\/2&#8243;][vc_column_text css=&#8221;.vc_custom_1759015853663{padding-top: 20px !important;padding-bottom: 20px !important;}&#8221; color=&#8221;#fefefe&#8221;] Atherosclerosis Hardening of the Arteries [\/vc_column_text][\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1759015527111{margin-top: 60px !important;}&#8221;][vc_column][vc_tta_tour controls_size=&#8221;md&#8221; active_section=&#8221;1&#8243;][vc_tta_section title=&#8221;What is hardening of the arteries?&#8221; tab_id=&#8221;1759012899351-dcaaabe1-cd5c&#8221;][vc_column_text css=&#8221;&#8221;] What is hardening of the arteries? Hardening of the arteries (or atherosclerosis) is a degenerative disease of large and&hellip;<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-18","page","type-page","status-publish","hentry","entry","no-media"],"_links":{"self":[{"href":"https:\/\/cmcdeploytwo.co.nz\/vsoanz\/index.php\/wp-json\/wp\/v2\/pages\/18","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cmcdeploytwo.co.nz\/vsoanz\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/cmcdeploytwo.co.nz\/vsoanz\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/cmcdeploytwo.co.nz\/vsoanz\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/cmcdeploytwo.co.nz\/vsoanz\/index.php\/wp-json\/wp\/v2\/comments?post=18"}],"version-history":[{"count":13,"href":"https:\/\/cmcdeploytwo.co.nz\/vsoanz\/index.php\/wp-json\/wp\/v2\/pages\/18\/revisions"}],"predecessor-version":[{"id":24,"href":"https:\/\/cmcdeploytwo.co.nz\/vsoanz\/index.php\/wp-json\/wp\/v2\/pages\/18\/revisions\/24"}],"wp:attachment":[{"href":"https:\/\/cmcdeploytwo.co.nz\/vsoanz\/index.php\/wp-json\/wp\/v2\/media?parent=18"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}