Carotid Artery Disease (A marker of cardiovascular health)

Beata Kus has worked for over 3 years as Sonographer at Preventicum where she performs the ultrasound examinations that form part of all our Check-Ups. Here, she has written an article on Carotid Artery Disease which is an indirect marker of arterial health and if severe can be a cause of stroke.

What is it and how is it caused?

Arteries are blood vessels that carry oxygen-rich blood to the heart and other parts of the body. The carotid arteries are located in the front of your neck and supply oxygenated blood to the part of the brain that controls thought, speech, personality and sensory and motor functions. Carotid artery disease is caused by atherosclerosis, a disease in which plaque builds up inside the arterial wall leading to obstruction. Plaque is made up of fat, cholesterol, calcium, fibrous tissue and other substances found in the blood. Over time, this plaque hardens and can narrow the arteries. This in turn, limits the flow of oxygen-rich blood to organs and other parts of our body downstream.

A normal carotid artery
A normal carotid artery

Significantly narrowed carotid arteries is a predictive factor for stroke

Carotid artery disease is responsible for nearly 50% of all transient ischemic attacks (TIAs) or “mini-strokes” and represents an increased risk of developing a true stroke, (CVA) heart attack (MI) and peripheral vascular disease. People with carotid artery disease also have a higher risk of death from coronary artery disease, aortic aneurysm, renal failure and complications due to ischemia, which is when there is an inadequate blood supply to an organ or part of the body, especially the heart muscle.

 

A carotid artery with plaque
A carotid artery with plaque

Detecting carotid artery disease

It is possible to have carotid artery disease without knowing it and in the UK it is usually diagnosed after a TIA. In a person showing no symptoms, carotid artery disease can be identified by a physical examination where a doctor listens to the blood flow in the arteries with a stethoscope which sometimes reveals a ‘whooshing’ sound,(carotid bruit) although this is not always heard. Follow up with an ultrasound scan can assess the degree of narrowing of the carotid artery as this is the most important predictor of stroke.At Preventicum we routinely scan the carotid arteries and measure wall thickness as a method of assessing the general health of the arterial tree.We are all born with pristine arterial walls which gradually thicken, harden and eventually narrow with age (hardening of the arteries).

Treatment

The treatment depends on the degree of changes or occlusion (blockage) presence of symptoms and risk factors. All measures are aimed at reducing the risk of cardiovascular disease. For many individuals lifestyle changes combined with drug treatment can reduce the risk of stroke. Only in severe conditions, surgical intervention (carotid endarterectomy) is required.

In my three years of practice at Preventicum I’ve had the opportunity to observe how the lining of the carotid arteries evolves over the years. The majority of our clients present with insignificant irregularities within their carotid vessels, however, some exhibit mild to moderate atherosclerotic changes (where the arteries have started to become blocked). This is usually seen in clients with higher risk factors like: increasing age, smoking, family history, diabetes, hypertension, sedentary lifestyle, metabolic syndrome, being overweight or obesity, unhealthy blood cholesterol levels, and an unhealthy diet.

Ultimately, after our comprehensive Check-Ups, most clients take their health and our medical advice seriously and make the recommended lifestyle adjustments. Our goal is to stop the disease from getting worse and prevent potentially life changing events. I’ve been able to observe that many clients returning for subsequent Check-Ups where their initial assessment has shown narrowing of the arteries, have made lifestyle changes and show a significant decrease of thickening and decrease of non calcified plaque. In some cases, I have even seen the carotid arteries returning to a healthy appearance which is very satisfying. The lifestyle changes that are good for carotid artery disease are the same recommendations for overall wellness. While changing habits can be hard, incremental lifestyle changes can reap big rewards. The strategies that have been shown to have the biggest impact for people who have, or are at risk for, narrowing of the carotid arteries include: statins (cholesterol lowering medicines) quitting smoking, good blood pressure control, healthy eating, aiming for a healthy weight, drinking alcohol in moderation and regular physical activity.

Beata Kus

Sonographer