Test Your Atherosclerosis Smarts

Atherosclerosis: You already know it's bad news. Hardening of the arteries is a leading cause of sickness and death in the United States. In 2005, roughly 870,000 people in this country died of cardiovascular disease largely caused by atherosclerotic problems. That's almost double the number of deaths from all cancers. You might already know what factors put you at risk -- smoking, high blood pressure, high cholesterol, diabetes, obesity, sedentary lifestyle, and age. But what do you know about other aspects of this common yet serious condition? Are the following statements true or false?

1. Atherosclerosis usually develops in areas of the arteries where blood is flowing smoothly, better enabling fatty plaques to form.

False. Fatty plaque deposits often form at artery branch points, where blood flows more turbulently. True, plaques may be scattered throughout various arteries, but they're more common at branch points, scientists believe. The turbulent blood flow increases risk of injury to artery linings. Once linings are damaged, fat, cholesterol, calcium, and other substances may collect at the injured sites and form atherosclerotic plaques.

2. Atherosclerosis usually does not cause any notable symptoms until an artery is more than 70% covered by plaque buildup.

True. When plaques form, they narrow the artery and reduce blood flow. But you probably won't notice signs right away. Usually, first symptoms don't turn up until the artery is narrowed by more than 70%. Then you may feel chest pain when you're physically active because the narrowed artery can't deliver enough oxygen-rich blood to your heart. However, some people feel no signs or symptoms and don't learn they have atherosclerosis until after a heart attack or stroke.

3. A bruit is an injured part of the artery wall.

False. A bruit is a sound -- specifically, an abnormal whooshing or swishing that indicates the presence of turbulent blood flow from an artery that may be partially blocked by atherosclerosis. Your doctor may hear a bruit in an artery while listening with a stethoscope during a physical exam. If an artery is severely blocked, though, there may not be a bruit.

4. Smoking increases atherosclerosis risk, but chewing tobacco does not.

False. Like smoking, chewing tobacco and snuff also boost the chances of getting atherosclerosis. Even secondhand smoke seems to raise risk. Smoking causes blood levels of carbon monoxide to go up, which may in turn increase risk of damage to artery linings. Tobacco use also raises LDL "bad" cholesterol and lowers HDL"good" cholesterol, constricts arteries and further decreases blood flow to tissues, and makes blood more likely to clot.

5. Atherosclerosis can lead to both heart attacks and stroke, but it can also do damage to the legs, kidneys, and intestines.

True. While most people associate atherosclerosis with damage to the heart and brain, the disease can affect various parts of the body. When plaque hardens and narrows arteries that supply blood to the legs, they may cramp and feel weak when you walk or run. When atherosclerosis affects arteries to the kidney and intestines, the inadequate blood flow can damage organ tissues.