What Is Atherosclerosis?

Atherosclerosis is a progressive disease that develops slowly when the arteries, a type of blood vessel that carries oxygen-rich blood from our heart to the organs and tissues around our body, become narrowed or hardened. It is caused by the buildup of fatty deposits called plaque, which consist of fats, cholesterol, and other substances. Over time, as the amount of plaque in the arteries increases, the narrowing makes it more difficult for the blood to flow freely and cardiovascular disease (a general term that is used to describe diseases that affect the heart or blood vessels) can develop.

Cardiovascular diseases that can be caused by atherosclerosis include:

• peripheral arterial disease (where a blockage develops in the arteries that deliver blood to your limbs, usually the legs),
• aortic disease (where the aorta, the body’s main artery, is unable to work properly),
• stroke (where the blood supply to the brain becomes disrupted), and
• coronary artery disease (where the coronary arteries, which are the main sources of blood supply to the heart, become narrowed or blocked), which can lead to angina or heart attack.

Although many people with atherosclerosis do not have any symptoms, some people experience pain in their chest, or in their arms or legs when exercising, a feeling of weakness and/or confusion, and may feel short of breath or tired most of the time.

What Causes Atherosclerosis?

Atherosclerosis can begin to develop in early childhood. High levels of fats and cholesterol in the blood are known to contribute because they make up some of the components of plaque. Damage or injury to the inner layers of arteries is also thought to be involved because the immune system responds to and seeks to repair the damage through a process called inflammation.

When inflammation is initiated, it causes blood cells and other substances to gather at the site of injury, and this can contribute to plaque starting to build up inside the arteries. Interestingly, there is evidence that the inflammation caused by inflammatory diseases such as rheumatoid arthritis, psoriasis, and inflammatory bowel disease can contribute to the development of atherosclerosis, and atopic dermatitis (more commonly known as eczema) may also be involved.

What Is Atopic Dermatitis?

Atopic dermatitis is an inflammatory skin condition that is usually long-term and recurrent, although in children it can improve or clear up completely as they get older. It causes the skin to be dry, cracked, itchy, and sore, and can range from occurring in small, localized patches to all over the body. Although the exact causes of atopic dermatitis are unknown, it is considered to be a systemic disease (a condition that affects the whole body rather than a single body part or organ) because the chronic inflammation that causes it often occurs in other organ systems as well as in the skin. It also often occurs in people who have allergies or asthma.

What Did This Study Investigate?

Because atopic dermatitis is an inflammatory disease and chronic inflammation has been linked to the development of atherosclerosis, it is possible that there is a relationship between people having atopic dermatitis and developing cardiovascular disease later in life. Some studies have found that the systemic inflammation caused by atopic dermatitis may double the risk of cardiovascular disease. Some research has suggested that the two may have an indirect relationship due to atopic dermatitis causing risk factors linked to increased risk of cardiovascular disease, such as sleep problems caused by itching, inactivity, and the use of corticosteroid treatments).

However, other research has suggested that there is a direct relationship caused by the excessive inflammation in the body that is independent of other factors. Recent research has shown that the levels of molecules in the blood that are prognostic (in other words, they can be used to indicate how a condition is likely to progress) for atherosclerosis and damage to the arteries are increased in skin and blood serum samples from patients with atopic dermatitis.

Most studies looking at whether there is a link between atherosclerosis and atopic dermatitis to date have involved adult patients. Considering that atherosclerosis can start to develop in early childhood, the authors of this study investigated whether early signs of atherosclerosis beginning to develop can be detected in children with atopic dermatitis and attempted to identify risk factors associated with both conditions. They compared a group of children who had atopic dermatitis with a similar number of children who did not have the disease who were alike in terms of factors like their age, weight, and height.

What Did the Study Show?

The results of the study showed that early signs of atherosclerosis were detectable in children with atopic dermatitis, with the length of time that they had had atopic dermatitis, the severity of their disease, and their age all associated with the likelihood of signs being present.

In particular, increases in a factor called carotid intima–media thickness were found to be associated with children having atopic dermatitis. Carotid intima–media thickness is calculated using a special type of ultrasound by measuring the thickness of the two most inner layers of the carotid arteries (the major arteries that supply blood to your brain, with one on each side of your neck), the intima and the media, and is used to assess whether atherosclerosis may be present. The greater the carotid intima–media thickness, the greater the likelihood that atherosclerosis is developing.

The authors of the study suggest that it may be important that children with atopic dermatitis be monitored for signs of atherosclerosis development and other risk factors that are known to be associated with cardiovascular disease. These include obesity, high levels of fats in the blood, and high blood pressure. Studies following the health of children with atopic dermatitis over longer periods of time are now needed to shed more light on the relationship between it and the development of atherosclerosis and cardiovascular disease.

Note: This post is based on an article that is not open-access; i.e., only the abstract is freely available.