Atherosclerosis , also known as hardening of the arteries , is one of the most common and consequential vascular diseases in industrialized nations – particularly among men from middle age onward. 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 serious complications such as heart attack or stroke.
Because atherosclerosis develops slowly over many years, it often goes undetected for a long time. This makes early detection and targeted measures to prevent its progression all the more important. This encyclopedia entry explains the causes, risk factors, symptoms, diagnostic methods, and treatment options, with a particular focus on men's health.
What is atherosclerosis?
Atherosclerosis is a chronic inflammation of the artery walls. The disease usually begins with small injuries to the inner lining of the blood vessels (endothelium), triggered by mechanical, chemical, or metabolic stimuli such as high blood pressure, smoking, or high blood sugar levels. Subsequently, substances such as cholesterol, immune cells, and calcium are deposited in the vessel wall. The body attempts to encapsulate these deposits, resulting in the formation of plaques.
These deposits gradually narrow the vessel diameter and make the artery less elastic. In advanced stages, a plaque can suddenly break off, 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, a low testosterone level can increase the risk of atherosclerosis.
Furthermore, classic risk factors such as visceral abdominal fat , high blood pressure , high stress , and lack of exercise are more prevalent in men. The tendency to avoid preventative medical checkups also contributes to atherosclerosis often being diagnosed too late in men.
Symptoms: When does atherosclerosis become noticeable?
In its early stages, atherosclerosis usually remains asymptomatic. Symptoms typically only appear when a blood vessel is narrowed by more than 70 percent – depending on which region is affected.
Heart (Coronary heart disease)
- Chest pain or tightness (angina pectoris)
- Shortness of breath during exertion
- Heart attack with complete vascular occlusion
Brain (cerebral atherosclerosis)
- dizziness
- Visual disturbances
- Speech disorders
- stroke
Legs (peripheral arterial occlusive disease)
- Calf pain when walking ("intermittent claudication")
- Cold or pale legs
- Poor wound healing
Early warning signs in men
Erectile dysfunction is an often overlooked sign of early-stage atherosclerosis. Because the blood vessels in the penis are very fine, this organ is particularly sensitive to circulatory problems. Therefore, potency problems can be an early indication of impaired vascular function.
Risk factors for atherosclerosis
Atherosclerosis develops through the interplay of various risk factors. The most important are:
- Smoke
- High blood pressure
- Unfavorable lipid profile (high LDL , low HDL , high triglycerides )
- Type 2 diabetes mellitus or insulin resistance
- Chronically elevated inflammation markers (e.g., CRP )
- Lack of exercise
- Unhealthy diet (high in sugar and fat)
- Visceral abdominal fat
- Stress and lack of sleep
- Family history
Diagnostics: How is atherosclerosis diagnosed?
Since the disease often progresses without symptoms, early diagnosis is crucial. Important methods for detecting 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) in cases of suspected peripheral arterial disease
- Exercise ECG in cases of suspected coronary artery disease
- CT angiography or cardiac MRI to visualize the blood vessels
Course and complications
If atherosclerosis remains untreated, it can lead to serious secondary diseases:
- 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?
The therapy depends on the severity of the illness and includes:
Lifestyle modification
- Healthy, plant-based diet (e.g. Mediterranean diet)
- Regular endurance training
- Quit smoking
- Stress reduction and sleep optimization
- Weight loss in cases of obesity
Drug therapy
- Statins to lower LDL cholesterol
- Blood pressure lowering medication
- Blood thinners such as aspirin
- Antidiabetic drugs for blood sugar imbalance
Invasive procedures (in case of complications)
- Balloon catheter with stent insert
- Bypass surgery for advanced vascular occlusions
Conclusion
Atherosclerosis is a serious disease that occurs particularly frequently and early in men – often unnoticed. Early diagnosis and targeted lifestyle changes can significantly slow or even halt the progression of the disease. Regular health check-ups, a conscious diet, and exercise are the most important protective factors against this "silent" danger in the blood vessels.
