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Atherosclerosis: A Symptom of Endothelial Dysfunction

Atherosclerosis, the build-up of plaques within the walls of the arteries, is caused when the endothelial cells that line the thousands of miles of blood vessels become dysfunctional. We also know that endothelial dysfunction is caused by the same heart risks that initially damage the endothelium.

Based on new clinical findings, many leading cardiac researchers now believe that endothelial dysfunction, considered as “the ultimate risk of the risk factors”, is a disease unto itself and that this disease is what causes damage to the vessels of the heart, not atherosclerosis. Furthermore, this dysfunction is triggered by an inflammatory response to the damaged endothelium. Atherosclerosis, and the subsequent plaques and arterial blockages and heart attacks that it causes, are manifestations of this endothelial dysfunction.

Atherosclerosis timeline

“The emphasis should be on prevention both from a population basis and by better identification of high-risk individuals decades before clinical cardiovascular disease occurs.”

Elaine M. Urbina, M.D., et al

Noninvasive Assessment of Subclinical Atherosclerosis in Children and Adolescents.
A Scientific Statement From the American Heart Association (2009)

The New Diagnostic Paradigm

With many leading researchers now looking at endothelial dysfunction as the risk of all heart risk factors, with atherosclerosis but a symptom of the on-going systemic dysfunction, traditional thinking about heart disease – its diagnosis and treatment – is starting to shift.

Treatments to repair the damage caused by ruptured plaque (stent, medication, angioplasty, CABG) are now viewed as palliative, not curative, in that they don’t heal the damaged endothelium.
They only delay the onset of another plaque rupture.

However, by turning the focus to the health of the endothelium at a much earlier stage in life, by assessing it with non-invasive EndoPAT™ testing, and keeping a healthy,
balanced lifestyle, levels of inflammation can be reduced and the health of the endothelium can be improved, oftentimes dramatically. This is evidenced by rising EndoPAT™ scores.

Each year in the United States, about 785,000 people will have a heart attack for the first time, while 470,000 will have a repeat attack. In about 20% of the cases, death will result. Early diagnosis with EndoPAT, however, offers a real chance to help reduce these figures significantly.

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