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William H. McMicken, M.D.
2335 Huntingdon Pike
Huntingdon Valley, Pennsylvania 19006
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"Hardening of the Arteries"
Inevitable or Preventable?

Arteriosclerosis and Atherosclerosis

"Hardening of the arteries" is a phrase that conjures up an ominous picture for a concerned person seeking to maintain good health. As one's years advance, so do the diseases of aging, most of which are intimately related to this "hardening" process, called arteriosclerosis. A medical school classmate of mine recently shared with me the description of the aging process he had heard. He said, "This is the time of life when things that should be dry get wet, things that should be wet get dry, things that should be soft get hard, and things that should be hard get soft." This description easily encompasses a variety of abnormalities that afflict older people… such things as urinary incontinence, tearing eyes, runny noses, wet or dry coughs, dry eyes, dry mouth, dry skin, absence of vaginal lubrication, hardening of the arteries, stiffening of the joints and muscles, cataracts, and sexual impotence.

Arteriosclerosis is the name of the process responsible for the major diseases of aging. As do many terms in medicine, this name comes directly from Greek, arteria (artery), and sclerosis (hardening). It is a condition in which the blood vessel wall becomes thickened, harder, and less elastic. Sometimes calcium deposition is also seen in the artery wall. This causes the inside of the artery, called the lumen, to narrow, and blood flow to diminish in the arteries affected. When deposits in the arteries are plaques of cholesterol and fats, or lipids, the condition is called atherosclerosis, that is a special kind of arteriosclerosis. The mechanism of damage in arteriosclerosis is the decrease in circulation to vital structures that results from the narrowed arteries.

Arteriosclerotic Diseases

The specific disease entity, and the symptoms that can occur, depend on which blood vessels are affected. While arteriosclerosis tends to be a generalized condition, some blood vessels may be affected earlier or worse than others. When the blood flow oxygenating and nourishing a particular part of the body fails, a disease process develops there. The important "target organs" that may be damaged are the brain, the heart, and the kidneys.

If the arteries affected lead to the head, the signs and symptoms that can occur are stroke, seizures, paralysis, fainting spells, "black-outs", falls, loss of memory and intellectual capacities, dizziness, or visual impairment. "Hardening" or fatty deposits in the coronary arteries of the heart can result in angina pectoris, heart attack, heart rhythm disturbances, heart failure, or sudden death.

Impairment of blood flow to the kidney can cause high blood pressure, and kidney failure, sometimes called uremia. If the arteries to the legs are affected, one may have pain and muscle cramping with exercise, called claudication. Skin ulcers from poor circulation to the surface can happen, or even gangrene of the extremity requiring amputation. Erection and hardening of the penis with sexual arousal depends on adequate arterial blood flow, so impotence may be arteriosclerotic in origin. Obstruction of the arteries to the intestinal tract can also occur, resulting in symptoms of abdominal pain after eating, and malnutrition. When complete blockage of the arteries to the bowel (mesenteric arteries) occurs, gangrene of large portions of the bowel may develop. When this happens, death follows unless the gangrenous intestine is promptly removed by a surgeon. If sufficient bowel is lost, such a person will then be permanently dependent on an intravenous solution for total nutrition.

The arteriosclerotic complications described above are associated with the diseases that will eventually kill most of us, and are worthy of close attention, research, and treatment. Considering the amazing advances in technological and scientific knowledge in the medical field over the past 50 years, one might wonder why this problem is not closer to a solution than it is.

Arteriosclerosis In Medical History
Prehistoric to Modern Times
The changes associated with arteriosclerosis have been recognized for thousands of years. Studies have shown that even prehistoric man had arteriosclerosis. This can only be assumed, since there is no way to examine the arteries of ancient human beings. Only bones remain as fossils. Studies of prehistoric bones have demonstrated diseases such as degenerative arthritis, bone tumors, and bone infections. The oldest human "soft tissue" available for examination is that from preserved Egyptian mummies. The heart and arteries can be examined in mummies. The remains of Egyptian royalty who lived in 4,000 B.C. have been found to have advanced arteriosclerotic disease.

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