The underlying cause of cardiovascular disease is atherosclerosis. The general term arteriosclerosis is used to describe the thickening and hardening of the arteries that occurs as people get older. Atherosclerosis occurs when deposits of fatty substances, cholesterol, cell waste products, calcium and fibrin (a clotting material from blood) build up in the inner lining of the artery. The build-up is known as plaque and as it increases bleeding can occur, eventually leading to the formation of blood clots. If a clot blocks a whole artery, a heart attack or stroke can occur.

AtherosclerosisThe development of atherosclerosis can begin at a very early age and is usually not noticed until serious health problems such as a heart attack or stroke occur. About 13.5 million Americans know that they have the disease.

Atherosclerosis is a complex process and exactly how it begins or what causes it, is unknown. However, it seems likely that damage to the inner lining of blood vessels starts the process. Considerable evidence suggests that a high level of cholesterol is the most important factor contributing to the disease process. Certain types of cholesterol are vulnerable to oxidative damage by free radicals, and oxidized cholesterol is more damaging to arteries than unoxidized cholesterol. New research suggests that other compounds are also vulnerable to oxidation, including those in white blood cells known as macrophages, which can promote plaque formation by causing inflammation and the release of toxic substances that can damage cells.

Atherosclerosis can affect any area of the body. Blocked coronary arteries affect the heart, while narrowing of the carotid arteries of the neck may reduce mental functioning. Atherosclerosis of the leg arteries leads to intermittent claudication in which it is difficult to walk without pain; and clogging of the pelvic arteries affects sexual performance.

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