Symptoms vary based on affected arteries (Lippincott Review of Pathology):

• Coronary Arteries: Angina (chest pain), shortness of breath, or myocardial infarction (heart attack).
• Carotid/Cerebral Arteries: Transient ischemic attack (TIA), stroke symptoms (sudden numbness, speech difficulties).
• Peripheral Arteries: Claudication (leg pain during walking), non-healing ulcers.
• Renal Arteries: Hypertension or kidney dysfunction.

Early stages are often asymptomatic, emphasizing the need for proactive screening (Mayo Clinic).

Atherosclerosis stems from endothelial injury triggered by:

• Modifiable Factors:
  • Hyperlipidemia: Elevated LDL cholesterol and triglycerides (Comprehensive Pharmacy Review).
  • Hypertension: Accelerates arterial damage.
  • Smoking: Damages endothelium and promotes inflammation.
  • Diabetes: High glucose levels contribute to oxidative stress.
  • Obesity & Sedentary Lifestyle: Linked to metabolic syndrome.
• Non-Modifiable Factors: Age, male sex, and genetic predisposition (WHO).

Chronic inflammation plays a central role in plaque progression (Lippincott Textbook of Pharmacology).

Lifestyle Modifications:

• Diet: Emphasize fruits, vegetables, whole grains, and lean proteins; limit saturated fats and sodium (WHO).
• Exercise: ≥150 minutes/week of moderate activity.
• Smoking Cessation: Reduces cardiovascular risk by 50% within 1 year (BNF).
• Weight Management: Aim for BMI 18.5–24.9.

Pharmacological Interventions:

• Statins (e.g., atorvastatin): First-line for LDL reduction (Lange Textbook of Clinical Pharmacology).
• Antihypertensives: ACE inhibitors or ARBs for blood pressure control.
• Antiplatelets (e.g., aspirin): For high-risk patients, balancing bleeding risks (BNF).

Medications:

• Lipid-Lowering Agents: Statins, ezetimibe, or PCSK9 inhibitors for refractory cases.
• Antihypertensives: Beta-blockers and calcium channel blockers to reduce cardiac workload.
• Antiplatelets/Anticoagulants: Clopidogrel or warfarin to prevent thrombosis (BNF).

Surgical Interventions:

• Angioplasty & Stenting: To reopen narrowed arteries.
• Bypass Surgery: Redirects blood flow around blocked segments (Mayo Clinic).

Emerging Therapies:

• Anti-inflammatory drugs (e.g., colchicine) targeting plaque instability (Lippincott Textbook of Pharmacology).

Atherosclerosis remains a major contributor to global mortality, but its progression can be halted through early intervention. Combining lifestyle changes with evidence-based pharmacotherapy—guided by resources like the BNF and WHO guidelines—can significantly reduce risks. Regular health screenings and consultations with healthcare providers are essential for timely management.

Sources: British National Formulary (BNF), Mayo Clinic, World Health Organization (WHO), Lippincott Review of Pathology, Comprehensive Pharmacy Review, Lippincott Textbook of Pharmacology, Lange Textbook of Clinical Pharmacology