How Atherosclerosis vs. Arteriosclerosis Affects Arteries

"Vascular disease" is a term given to conditions that affect the blood vessels that carry oxygen and nutrients throughout the body. Two conditions within this category are atherosclerosis and arteriosclerosis, which are often confused.

Both conditions involve changes in the arterial walls. However, arteriosclerosis is the general thickening and hardening of the arteries, often due to aging, and atherosclerosis is a specific type of arteriosclerosis in which fatty deposits called plaque build up in the walls of the artery.

Atherosclerosis and arteriosclerosis both affect the arteries, but their impacts, causes, and health risks vary. Understanding their differences can reveal how vascular disease develops and affects overall health.

Arteries in Atherosclerosis vs. Arteriosclerosis 

In both atherosclerosis and arteriosclerosis, the arteries, which are the blood vessels that carry oxygen-rich blood from the heart to the rest of the body, change in a way that makes them less effective in doing their job.

A healthy artery has smooth, flexible walls so blood can flow through easily. With arteriosclerosis, the arterial walls become thickened and less elastic, which can restrict blood flow and make the heart have to work harder to pump blood through the body.

In atherosclerosis, the artery stiffness is due to plaque buildup within the arterial walls. Plaque is a sticky, fatty substance composed of cholesterol, calcium, and other substances. As plaque builds up, it narrows the arteries and can eventually block blood flow, leading to complications like a heart attack or stroke.

Atherosclerosis is typically the cause of coronary artery disease (CAD). While both atherosclerosis and arteriosclerosis involve artery changes, plaque formation in atherosclerosis can come with additional health risks.

Symptoms and Warning Signs

The symptoms of atherosclerosis and arteriosclerosis usually develop slowly over time and might not be noticeable until advanced. In the early stages, both conditions may have no noticeable symptoms.

However, as arteries become increasingly narrowed or hardened, signs of clogged arteries may present themselves, depending on which part of the body is affected. For instance, if the arteries supplying blood to the heart are affected, heart attack symptoms might be experienced.

Symptoms related to the heart may include:

• Chest pain or angina 
• Cold sweats
• Dizziness that’s sudden
• Fatigue 
• Nausea
• Shortness of breath 

When atherosclerosis affects the arteries leading to the brain, warning signs may involve stroke-like symptoms such as:

• Difficulty walking
• Facial drooping
• Headache
• Loss of vision
• Slurred speech 
• Sudden numbness or weakness 

When plaque buildup affects the arteries providing blood flow to the extremities (legs, feet, arms, and hands), symptoms such as coldness or weakness of the extremity may be noticed.

Arteriosclerosis may cause symptoms such as high blood pressure or decreased blood circulation to the extremities, leading to leg pain or cramping, often during physical activity. This is a condition known as claudication.

In arteriosclerosis, the heart has to work much harder to get blood through the body. Over time, this can lead to enlargement of the heart's left ventricle, which is the heart chamber that pushes blood through to the body. As time goes on, the enlarged heart can begin to fail. Symptoms of heart failure can include:

• Coughing or wheezing
• Fatigue
• Increased heart rate
• Lower extremity swelling
• Shortness of breath

Potential Causes

Arteriosclerosis and atherosclerosis are caused by a combination of things, including age, lifestyle, and sometimes family history. Arteriosclerosis happens naturally as the body ages. The arteries lose some of their flexibility over time, but this loss of flexibility can also be related to high blood pressure and obesity.

Risk factors for atherosclerosis include:

• Being overweight 
• Chronic stress
• Diabetes
• Family history of heart disease or high cholesterol
• High blood pressure
• Poor sleep
• Smoking

Testing Differences

Healthcare providers can use different tests to check for atherosclerosis or arteriosclerosis, or both.

For arteriosclerosis, a test often performed is the pulse wave velocity, which measures the strength and speed at which blood moves through the arteries. Monitoring blood pressure is important as well. An echocardiogram, which is an ultrasound of the heart, may be done to see if the heart is enlarged or not pumping well.

For atherosclerosis, which involves plaque buildup inside the arteries, different tests can determine the amount of plaque buildup. Commonly, blood tests such as inflammation markers, triglycerides, and lipoproteins are checked.

Imaging tests include cardiac magnetic resonance imaging (MRI) or cardiac computed tomography (CT) to view the arteries in the heart. An angiogram can directly evaluate if there are any blockages in the arteries, and an ultrasound during the procedure can see the amount of plaque buildup in the arteries.

Other tests include stress tests (performed on a treadmill or stationary cycle with monitoring) and an ankle-brachial index (measures blood pressure in the upper arm and ankle).

How Is Treatment Similar?

Lifestyle changes are one of the main ways both conditions are managed. This includes eating a heart-healthy diet low in saturated fats, added sugars, salt, and alcohol. Include fruits, vegetables, whole grains, and lean proteins such as legumes (beans and lentils), seeds, fish, and poultry.

Regular exercise is also important for keeping the arteries healthy, strengthening the heart and improving circulation. Quitting smoking is another important step, as smoking damages the arteries and can make both conditions worse.

In addition to lifestyle changes, medications can help. Medications that lower cholesterol, such as statins, are commonly prescribed to help reduce the amount of cholesterol that can build up. Blood pressure medications are also often used to help reduce strain on the blood vessels if you have high blood pressure.

Medications to prevent clotting (known as anticoagulants, or blood thinners, can be prescribed to help keep the blood flowing easily in the arteries.

In more advanced cases of atherosclerosis, procedures like angioplasty, in which a tiny balloon is used to widen a narrowed artery, or stent placement, a small tube that keeps an artery open, may be done to improve blood flow.

Possibility of Reversing Artery Changes

While the thickening and hardening of arteries in arteriosclerosis may not fully reverse, lifestyle changes can help slow the progression.

Eating a balanced diet rich in fruits, vegetables, whole grains, and healthy fats can help reduce blood pressure and prevent additional hardening of the arteries.

Regular exercise also helps, as it improves circulation and can help lower blood pressure. These healthy habits make a significant difference over time, helping the heart work more efficiently and reducing strain on the arteries.

For atherosclerosis, which involves plaque buildup, some studies suggest that certain changes may even reduce the amount of plaque in the arteries. Older medications like statins and newer cholesterol medications not only lower cholesterol but may also help shrink plaque slightly over time, reducing the risk of serious issues like heart attacks.

When paired with medication, a healthy lifestyle, including quitting smoking and managing stress, can support artery health and potentially slow down plaque buildup. While completely reversing artery changes may not be possible, these interventions can help reduce plaque and improve arterial health.

When to Contact a Healthcare Provider 

Knowing when to call a healthcare provider if you have concerns about atherosclerosis or arteriosclerosis is important. The first step is determining your risk by getting regular checkups.

If you have risk factors such as high blood pressure, high cholesterol, diabetes, or a family history of heart disease, regular checkups with a healthcare provider are important, even if you don’t have any symptoms.

Your healthcare provider can perform tests to detect early signs of atherosclerosis or arteriosclerosis, helping you take steps to protect your heart and arteries before more serious symptoms develop.

Seek emergency care for symptoms of decreased blood flow to the heart, such as:

• Chest pain
• Feelings of tightness in the chest
• Shortness of breath
  

Symptoms of reduced blood flow to the brain might be signs of a mini-stroke or stroke. These symptoms require emergent evaluation and include:

• Difficulty speaking
• Numbness on one side of the body
• Sudden weakness
• Trouble seeing

Pain or cramping in your legs, especially during activities like walking or climbing stairs, can be a sign of poor blood flow in the arteries of the legs and should be checked out.

Summary 

Two main types of vascular disease are arteriosclerosis and atherosclerosis, which both affect the arteries but differ in cause. Arteriosclerosis is the thickening and hardening of artery walls, often due to aging. Atherosclerosis, a specific kind of arteriosclerosis, happens when plaque builds up in the arteries, narrowing them and increasing the risk of heart attack or stroke.

Symptoms for both diseases may go unnoticed until advanced and vary depending on which arteries are affected. Lifestyle changes like a healthy diet, exercise, and avoiding smoking help manage both conditions, along with medications to lower cholesterol and blood pressure. Early testing and regular check-ups can also catch these conditions before they become severe.