So what are some other risk factors
Well, high blood pressure.
Remember, the biggest risk
for the hardening of the vessels,
is cardiovascular events like
an MI or a stroke.
You end up with something breaking off
and clotting off an important vessel.
So I'm not perfusing my heart muscle
or perfusing my brain.
High blood pressure puts me at an increased
risk for one of those events.
Smoking is another one, really
hard habit to quit.
If you or your patients are smokers,
that's a challenge to help someone walk
through the process of stopping smoking.
Now, the third one you're
already familiar with, right?
That elevated LDL cholesterol.
Remember, that's the one we
most want to control,
is the LDL level we want to get lower.
We want to increase the HDL
or the good cholesterol.
So when you're working with your patients,
or even thinking through your
own personal health,
controlling blood pressure,
stopping smoking or making
sure you don't start,
and lowering the LDL cholesterol
are great ways to lower your risk
factors for atherosclerosis.
So we keep throwing that word around,
and it's a hard one to say, isn't it?
It's a tongue twister. But we've got a graphic
here to show you kind of what happens.
Now look at the graphic. You see the artery.
The endothelium is that lining
inside the artery,
and you've also got smooth muscle.
Now, the yellowish, kind of, goopy stuff there,
those are lipids and calcium,
and just comecellular debris, kind of,
the extra trash that's in there.
So you can see that it's starting
to build up in people.
That's a hardening or a narrowing
of the artery
that's caused up by a buildup of plaque.
Well, what's plaque?
That's that yellow stuff right there;
lipids and calcium and that cellular debris.
So when someone has atherosclerosis,
they have this buildup of this kind of
plaque-y, trashy stuff in their vessels.
It makes them stiffer and prone
to things breaking off
and lodging in further areas
down the pipeline,
and you end up having something like
an MI, a heart attack, or a stroke.
Okay, so, you already knew
that atherosclerosis is not a good thing,
right? You knew you didn't want it,
but we want you to be very clear,
this is what we're trying to avoid
by taking statins
because we want less of the plaque buildup
and statins can help us get to that goal.
Less plaque buildup means vessels
that are able to move better.
They're not as stiff, and they're not as
narrowed from a buildup of plaque.
So, how does atherosclerosis happen?
Let's look at it step by step.
On the right hand side, you
see at the very top
what a normal artery looks like.
See, it's open, it's wide, it's
clear, there's nothing there.
Then you have like an early
injury to the endothelium.
Remember, that's the lining of that vessel.
Then it starts to build up and you
can see in that third picture,
you've got atherosclerosis.
All that trash and debris and lipids are
starting to become this mass
how much the blood has room to move through.
Now, the bottom one is complete blockage,
okay? So, this is a very sad story.
When you start with a normal artery, you
end up with a complete blockage,
then you have an area of occlusion. Look
at the picture of the heart there.
You see that black area? That's
to represent tissue death.
Because when the blood supply
is cut off to tissue,
then you have muscle damage and
death if we can't resolve that quickly.
So, atherosclerosis is this gradual
process of hardening and narrowing
of the arteries.
Now, before you get too depressed,
look, it's a process.
So we can intervene at any point
and help ourselves or help our
patients become healthier,
and lower their risk of a heart
attack or a stroke
just by intervening with
dietary and medications.
So, it's this chronic inflammatory process,
which is actually a good thing, right?
We've got time to make a difference.
So you have damage to the endothelium,
see that? Early injury.
Then you have atherosclerosis, that
building up of that plaque,
and what we want to avoid is that
build up and a complete blockage.
So that's the process of atherosclerosis.
How we end up with a --
starting from a normal artery, all
the way down to an event
like a heart attack or an MI.
See, those LDLs, remember,
those are the bad cholesterol, remember?
When we have that damage
to the endothelium,
the LDLs cross that damaged endothelium
into the wall of the artery.
So in overtime, that cholesterol becomes
part of that plaque,
right, that atherosclerosis.
So then the circulation is
it's got less area to pump through
and you have the increased
risk for stroke or MI.