(See also Atherosclerosis Atherosclerosis Atherosclerosis is characterized by patchy intimal plaques (atheromas) that encroach on the lumen of medium-sized and large arteries; the plaques contain lipids, inflammatory cells, smooth muscle... read more .)
Arteriosclerosis is a general term for several disorders that cause thickening and loss of elasticity in the arterial wall.
Atherosclerosis Atherosclerosis Atherosclerosis is characterized by patchy intimal plaques (atheromas) that encroach on the lumen of medium-sized and large arteries; the plaques contain lipids, inflammatory cells, smooth muscle... read more , the most common form, is also the most serious and clinically relevant because it causes coronary artery disease Overview of Coronary Artery Disease Coronary artery disease (CAD) involves impairment of blood flow through the coronary arteries, most commonly by atheromas. Clinical presentations include silent ischemia, angina pectoris, acute... read more and cerebrovascular disease Overview of Stroke Strokes are a heterogeneous group of disorders involving sudden, focal interruption of cerebral blood flow that causes neurologic deficit. Strokes can be Ischemic (80%), typically resulting... read more . Atheromatous disease is characterized by the atherosclerotic plaque, which is a vascular lesion composed of lipids, inflammatory and smooth muscle cells, and a connective tissue matrix that may contain thrombi in various stages of organization and calcium deposits.
Nonatheromatous forms of arteriosclerosis include
Nonatheromatous arteriosclerosis causes intimal thickening and weakens and disrupts the elastic lamellae. The smooth muscle (media) layer atrophies, and the lumen of the affected artery widens (becomes ectatic), predisposing to aneurysm Overview of Aortic Aneurysms Aneurysms are abnormal dilations of arteries caused by weakening of the arterial wall. Common causes include hypertension, atherosclerosis, infection, trauma, and hereditary or acquired connective... read more or dissection Aortic Dissection Aortic dissection is the surging of blood through a tear in the aortic intima with separation of the intima and media and creation of a false lumen (channel). The intimal tear may be a primary... read more . Hypertension is a major factor in development of aortic arteriosclerosis and aneurysm. Intimal injury, ectasia, and ulceration may lead to thrombosis, embolism, or complete arterial occlusion.
Nonatheromatous arteriosclerosis is usually asymptomatic until complications (eg, aneurysm) develop. It may be incidentally detected during imaging tests done for unrelated reasons.
There is no treatment for nonatheromatous arteriosclerosis beyond control of typical cardiovascular risk factors (eg, hypertension Hypertension Hypertension is sustained elevation of resting systolic blood pressure (≥ 130 mm Hg), diastolic blood pressure (≥ 80 mm Hg), or both. Hypertension with no known cause (primary; formerly, essential... read more , dyslipidemia Dyslipidemia Dyslipidemia is elevation of plasma cholesterol, triglycerides (TGs), or both, or a low high-density lipoprotein cholesterol level that contributes to the development of atherosclerosis. Causes... read more ).
Arteriolosclerosis affects distal arteries in patients with diabetes Diabetes Mellitus (DM) Diabetes mellitus is impaired insulin secretion and variable degrees of peripheral insulin resistance leading to hyperglycemia. Early symptoms are related to hyperglycemia and include polydipsia... read more or hypertension Hypertension Hypertension is sustained elevation of resting systolic blood pressure (≥ 130 mm Hg), diastolic blood pressure (≥ 80 mm Hg), or both. Hypertension with no known cause (primary; formerly, essential... read more .
Hyaline arteriolosclerosis affects small arteries and arterioles in patients with diabetes; typically, hyaline thickening occurs, the arteriolar wall degenerates, and the lumen narrows, causing diffuse ischemia, especially in the kidneys.
Hyperplastic arteriolosclerosis occurs more often in patients with hypertension; typically, laminated, concentric thickening and luminal narrowing occur, sometimes with fibrinoid deposits and vessel wall necrosis (necrotizing arteriolitis). Hypertension Hypertension Hypertension is sustained elevation of resting systolic blood pressure (≥ 130 mm Hg), diastolic blood pressure (≥ 80 mm Hg), or both. Hypertension with no known cause (primary; formerly, essential... read more promotes these changes, and arteriolosclerosis, by increasing arteriolar rigidity and increasing peripheral resistance, may help sustain the hypertension.
Mönckeberg arteriosclerosis (medial calcific sclerosis) affects patients > 50; age-related medial degeneration occurs with focal calcification and even bone formation within the arterial wall. Segments of the artery may become a rigid calcified tube without luminal narrowing. The diagnosis is usually obvious by plain x-ray. This disorder is clinically important only because it can greatly reduce arterial compressibility, causing extremely but falsely elevated blood pressure readings.
Nonatheromatous arteriosclerosis causes thickening and loss of elasticity of the arterial wall in the absence of obvious atheromatous plaque.
There are two variants of nonatheromatous arteriosclerosis: arteriolosclerosis and Mönckeberg arteriosclerosis.
Diabetes, hypertension and age are risk factors for the development of nonatheromatous arteriosclerosis.