Atherosclerosis, also known as hardening of the arteries, is one of the most common and consequential vascular diseases in industrialized nations – particularly in men from middle age onwards. The disease leads to the formation of deposits of fats, cholesterol, calcium, and inflammatory cells in the arteries. These so-called plaques can obstruct blood flow and cause severe complications such as a heart attack or stroke.
Since atherosclerosis progresses insidiously over many years, it often remains undetected for a long time. It is therefore all the more important to recognize the disease early and prevent its progression through targeted measures. This dictionary entry explains the causes, risk factors, symptoms, diagnostic methods, and treatment options, with a special focus on men's health.
What is Atherosclerosis?
Atherosclerosis is a chronic inflammation of the arterial walls. The disease usually begins with small injuries to the inner vascular wall (endothelium), triggered by mechanical, chemical, or metabolic stimuli such as high blood pressure, smoking, or high blood sugar levels. As a result, substances such as cholesterol, immune cells, and calcium accumulate in the vessel wall. The body tries to encapsulate these deposits, and plaques form.
These deposits gradually narrow the vessel diameter and make the artery less elastic. In advanced stages, a plaque can suddenly rupture, leading to the formation of a blood clot (thrombus). This clot can completely block the vessel – with acutely life-threatening consequences.
Why Does Atherosclerosis Particularly Affect Men?
Studies indicate that men are affected by atherosclerosis significantly earlier and more frequently than women. This is partly due to hormonal differences: the female hormone estrogen has a protective effect on blood vessels, while in men, low testosterone levels can increase the risk of atherosclerosis.
Furthermore, classic risk factors such as visceral belly fat, high blood pressure, high stress, and lack of exercise are more prevalent in men. The tendency to avoid medical check-ups also contributes to atherosclerosis often being diagnosed too late in men.
Symptoms: When Does Atherosclerosis Become Noticeable?
In its early stages, atherosclerosis is usually symptom-free. Symptoms typically only appear when a vessel is more than 70 percent narrowed – depending on the affected region:
Heart (Coronary Artery Disease)
- Chest pain or tightness (angina pectoris)
- Shortness of breath during exertion
- Heart attack in case of complete vessel blockage
Brain (Cerebral Atherosclerosis)
- Dizziness
- Vision disturbances
- Speech disorders
- Stroke
Legs (Peripheral Artery Disease)
- Calf pain when walking ("window shopper's disease")
- Cold or pale legs
- Poor wound healing
Early Warning Signs in Men
An often overlooked indication of incipient atherosclerosis is erectile dysfunction. Since the blood vessels in the penis are very fine, this organ reacts particularly sensitively to circulatory disorders. Impotence problems can therefore be an early sign of impaired vascular function.
Risk Factors for Atherosclerosis
Atherosclerosis develops through the interaction of various risk factors. The most important are:
- Smoking
- High blood pressure
- Unfavorable lipid profile (high LDL, low HDL, high triglycerides)
- Type 2 diabetes mellitus or insulin resistance
- Chronically elevated inflammatory markers (e.g., CRP)
- Lack of physical activity
- Unhealthy diet (high in sugar and fat)
- Visceral belly fat
- Stress and sleep deprivation
- Family history
Diagnosis: How is Atherosclerosis Diagnosed?
Since the disease often progresses without symptoms, early diagnosis is crucial. Important methods for diagnosing atherosclerosis include:
Blood Tests
- Total cholesterol, LDL, HDL
- Triglycerides
- Lipoprotein(a)
- C-reactive protein (CRP)
- HbA1c (long-term blood sugar)
- Homocysteine
Imaging Procedures and Functional Tests
- Duplex ultrasound of the carotid arteries to measure intima-media thickness
- ABI test (ankle-brachial index) for suspected PAD
- Stress ECG for suspected coronary artery disease
- CT angiography or cardiac MRI to visualize blood vessels
Course and Complications
If atherosclerosis remains untreated, severe secondary diseases can occur:
- Heart attack
- Stroke
- Chronic kidney diseases
- Peripheral circulatory disorders
- Erectile dysfunction
- Heart failure
Furthermore, an advanced plaque can rupture and trigger an acute blood clot, often with a sudden, severe course.
Treatment: What Helps Against Atherosclerosis?
Therapy depends on the severity of the disease and includes:
Lifestyle Modification
- Healthy, plant-based diet (e.g., Mediterranean diet)
- Regular endurance training
- Smoking cessation
- Stress reduction and sleep optimization
- Weight reduction for overweight individuals
Medication Therapy
- Statins to lower LDL cholesterol
- Blood pressure medication
- Blood thinners such as aspirin
- Antidiabetics for blood sugar dysregulation
Invasive Procedures (for complications)
- Balloon catheter with stent placement
- Bypass surgery for advanced vascular occlusions
Conclusion
Atherosclerosis is a serious disease that occurs particularly frequently and early in men – often unnoticed. With early diagnosis and targeted lifestyle changes, the course of the disease can be significantly slowed down or even stopped. Regular health check-ups, a conscious diet, and exercise are the most important protective factors against the "silent" danger in the blood vessels.