The most common form of arteriosclerosis, marked by cholesterol-lipid-calcium deposits in the walls of arteries.
ETIOLOGY: Risk factors for atherosclerosis include tobacco abuse, diabetes mellitus, abnormal blood lipid concentrations, hypertension, family history, male gender, increased age, sedentary lifestyle, and obesity. The role of vascular inﬂammation due to chronic infections (e.g., with chlamydia or cytomegalovirus) and the part played by elevated homocysteine levels are topics of active research.
SYMPTOMS: Symptoms may develop in any organ system with a blood supply diminished by atherosclerosis. Commonly these symptoms include angina pectoris, intermittent claudication, strokes, transient ischemic attacks, and renal insufﬁciency.
TREATMENT: Treatment includes regular exercise, smoking cessation, and a dietary regimen of low-cholesterol and low-fat foods. Medical treatment of hypertension, lipid disorders, and diabetes mellitus is also helpful. Angioplasty, atherectomy, or arterial bypass graft operations are beneﬁcial for selected patients.
PATIENT CARE: The patient and family are taught about risk factors associated with atherosclerosis, and the health care professionals help the patient modify these factors. Patients who smoke cigarettes are encouraged to enroll in smoking cessation programs. Community-based plans and programs to change sedentary activity patterns, reduce stress, control obesity, and decrease saturated fat intake to control triglyceride and cholesterol levels are explored with the patient. The nurse or other healthcare professional refers the patient for medical treatment to control hypertension and diabetes mellitus and supports the patient’s efforts to cooperate with lifestyle and health care changes. Regular exercise of a type and extent appropriate for the patient’s health and adequate rest are prescribed. The patient is informed of the need for long-term follow-up care to prevent a variety of body system complications.