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Localization of Atherosclerosis

A critical feature of atherosclerosis that has been historically underutilized is the localization of plaques, that is, the fact that severe plaques form on a region-specific as well as a site-specific basis. Despite the presence of systemic inflammation, severe stenosis is not systemic. Why is it that atherosclerosis does not occur in the arteries of the arms, in the veins, the intramyocardial muscles or intramyocardial arteries? Furthermore, why is it that this important disease initially occurs primarily at arterial bifurcations?

Atherosclerotic plaques do not form uniformly throughout the body. They are found in the large arteries that feed the heart and brain, which are close to the heart and absorb the abrasive injury caused by thick blood as it is punched out of the left ventricle. Plaques are also found in the arteries of the legs, where, because of the pull of gravity in a person standing upright, the blood is accelerated and increases the shear stress against the femoral arteries.      

The same blood passes through these areas passes through the veins and other parts of the body; therefore, biochemical, immunologic and infectious theories seem to be unable to explain the region and site-specificity of the lesions.

Hence, new insights are needed in the understanding of this disease to clearly identify the elusive initiating factor. There is a need to look at other factors that may affect the development of cardiovascular disease and to develop further understanding of the disease process in order to pinpoint new areas of targeted intervention.

Elevated blood viscosity is the only parameter that explains why atherosclerotic stenosis occurs in certain regions of the body and not in others. Measuring your patient’s blood viscosity enables you to determine the ability of your patient’s blood to flow and the physical injury that the blood can inflict on the arterial walls. This can give you an additional level of insight in prescribing and monitoring a treatment regimen that optimizes circulatory health.

Since the circulatory system is a closed system, the viscosity or thickness of what the heart is pumping can play a crucial role in determining the workload of the heart. An increase in blood viscosity will require the heart to work harder in order to provide the same level of perfusion to the tissues and organs of the body. An overworked heart is an inefficient heart – one that is more likely to become enlarged and ultimately fail. Blood viscosity determines not only how hard the heart has to work to circulate the blood, but also the level of physical injury that the blood can cause to the inner walls of the arteries. Thick blood is abrasive and can trigger the inflammatory process that leads to atherosclerosis.

 

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