Myth Busting! Clogged Artery Edition
Myth busting the clogged artery is a great topic for those science nerds (like me), avid watchers of MythBusters, and those who like to dig into everything to learn about the mechanics behind the scenes. This will also be an easy read for those who are very trusting of common knowledge or what their doctor tells them. Sometimes common knowledge and your doctor are wrong. Today we are going to going to change what you think you know. There will be new info for both science nerds and trusting patients!
You won’t catch me watching T.V. very often but if you do, I will be tuned into the Discovery Channel’s MythBusters. They take on science ideas and put them to the test. Based upon their experiments they will deem the idea a fact, plausible, or they will bust the myth. It’s the same philosophy I like to bring to my work with patients to help them find answers.
Test It!
Today we are going to look at one of the medical field’s most prolific myths, the clogged artery. It is spread on the internet, by friends, by neighbors and even by our doctors. Many people believe plaque builds on the wall of the artery which then leads to clogging and a stroke or heart attack. Some doctors know how it works but don’t have time to explain it to their patients. The myth keeps going.
You can even find this on a common resource many turn to when they have medical questions, WebMD. Don’t worry, most people have been there googling their symptoms at 2 a.m. Here’s what they say, “Clogged arteries result from a buildup of a substance called plaque on the walls of the arteries. Arterial plaque can reduce blood flow or, in some instances, block it altogether.”(1)
Is this how it actually all goes down? No, so lets take a look at what really happens. Its important we understand the mechanics of our arteries and body if we are going to make a difference in the heart disease arena. And most importantly for our own health.
Plaque does not form ON the walls of the arteries. It actually forms IN the arterial wall. The pictures from any scientific textbook or google image search on plaque from a source that has any credibility, represent this specific point. The plaque doesn’t sit within the bloodstream on the blood vessel wall. It lies underneath the arterial wall. This myth persists even though it leads to some damaging assumptions about how we prevent strokes and heart attacks. (2)
So How Does Plaque Get There?
So if it’s not lining the arterial wall how does it get inside the wall? Inflammation. The plaque can’t make it into the arterial wall without inflammation being present. The inflammation damages the arterial wall while breaking down LDL making them smaller and that leads to plaque formation.
Think of the artery wall like it’s a tennis net and the plaque is the tennis balls. A tennis net usually keeps the tennis balls from getting through. The tennis balls can only get through the tennis net if they are smaller than the holes in the net. If LDL are broken down they can pass through.
Once they get through, they build up until they rupture. Once it ruptures the blood starts clotting as the body is supposed to when there is a bunch of junk in the blood. Then if the clot builds up big enough it is going to block an artery. We have lots of arteries in our hearts and brains. That’s what leads to heart attack or stroke.
How the Myth Damages Our Approach
How are clogged arteries prevented for the majority of heart patients? With a statin medication that lowers cholesterol. So now after all you know from our myth busting, you wonder what does cholesterol lowering have to do with the plaque in my artery walls? Now you are hearing me. It has nothing to do with preventing heart disease and it can increase your risk for a stroke.
Cholesterol has always gotten a bad rep. It’s there at the site of plaque formation so it was a assumed that it was the cause of the plaque. Just because the police are at the scene of a crime doesn’t mean they are the ones that caused the crime. Whenever there is damage or inflammation, cholesterol has to go there to protect and heal the area. So cholesterol isn’t the bad guy here, cholesterol is the police.
Cholesterol is doing its job is to heal and protect. While the body is doing its job when it sends the cholesterol there but some view that as a bad thing. This misconception leads to the frequent prescription of cholesterol lowering medications.
The statin lowers the cholesterol in the blood but it doesn’t remove the plaque. The only thing that removes the plaque is the HDL. It’s the component of the whole cholesterol picture that takes the plaque out of the artery. The medication does not lead to reduced heart disease and does not prevent stroke.
Control the Clogged Artery Myth
If you know the mechanism of how the clogged artery happens you have the tools to do something about it. And prevent it- that’s the difference maker.
Your doctor should be measuring to see if the environment is right for plaque formation. Instead of cholesterol numbers make sure your doctor is looking at inflammation numbers. Make sure inflammation is not affecting your cholesterol profile or arterial wall strength. There are ways to remedy inflammation that don’t require the side effects of a statin medication.
We busted the persistent myths of the clogged artery and looked at what causes heart disease and strokes. Don’t leave it at that if you have concerns about heart disease or stroke. Take the MythBusters approach to those concerns and get them tested with a doctor you trust.
By Dr. Greg Abbott
To learn more check out Cholesterol: Devil, Angel or Neither
Reference
(1) https://www.webmd.com/heart-disease/clogged-arteries-arterial-plaque#1
(2) https://bjsm.bmj.com/content/bjsports/51/15/1111.full.pdf