Atherosclerosis, or hardening of the arteries, occurs when the inner walls of arteries accumulate excess substances, such as fats and calcium, beyond what is necessary for the body. This thickens the inner walls of the arteries over time, resulting in reduced flexibility and impaired blood flow. Eventually, this leads to hardening of the arteries and, ultimately, narrowing of the blood vessels. The risk factors that contribute to the development of the disease include the following: 

• Aging, particularly in individuals aged 40 and above, due to changes in blood vessels as one gets older.
• High blood pressure, which can cause damage to the blood vessels and lead to the formation of wounds or lesions.
• Elevated levels of triglycerides (TG) in the blood, which is a type of fat stored in the body for energy. Excessive accumulation of triglycerides can lead to blockages in the blood vessel walls.
• Diabetes, which can cause inflammation throughout the body, including in the blood vessels and nerves.
• Obesity or overweight, resulting from the accumulation of excess fat in the body beyond its capacity to burn. This can lead to inflammation of the blood vessels and ultimately atherosclerosis.
• Insulin resistance, where the body responds less to insulin than normal, leading to increased insulin production to regulate glucose uptake by cells. If glucose uptake is insufficient, blood glucose levels rise, which can also contribute to blood vessel damage. This condition is considered a precursor to diabetes.
• High levels of cholesterol in the blood, which can accumulate along the blood vessel walls.
• Family history of vascular diseases.

• Consuming unhealthy foods, such as those high in cholesterol, fried foods, and those with a strong taste.
• Smoking, as it contains nicotine, carbon monoxide, as well as heavy metals and other residual substances, which are absorbed into the bloodstream through the lungs.
• Excessive alcohol consumption, which affects blood cholesterol and triglyceride levels.
• Lack of exercise.
• High levels of C-reactive protein (CRP), which is a protein produced by the body during inflammation. It can be used to assess the risk of developing atherosclerosis.

• Symptoms of atherosclerosis in the coronary arteries, which lead to coronary artery disease, include:

1. Chest pain or discomfort (angina), which may radiate to other areas such as the neck, jaw, shoulder, back, or arms.
2. Fatigue during physical exertion or exercise.
3. Dizziness or lightheadedness due to sudden drops in blood pressure.
4. Loss of consciousness or sudden cardiac death.

• Symptoms of atherosclerosis in the brain, which is one of the causes of stroke, include:

1. Weakness or numbness in the muscles, often accompanied by facial drooping, arm or leg weakness, and difficulty speaking or understanding speech
2. Dizziness or vertigo, with issues maintaining balance and walking steadily.
3. Paralysis or inability to move certain parts of the body, known as hemiparesis or hemiplegia.

• Atherosclerosis in the kidneys can lead to reduced blood flow to the kidneys,
  affecting their function and eventually leading to chronic kidney disease.
• Atherosclerosis in other organs, such as the arms and legs
  Lead to Peripheral Arterial Disease (PAD). This condition causes symptoms in the peripheral parts of the body, such as the arms, legs, hands, and feet. Common symptoms include pain, fatigue, and numbness due to ischemia, or reduced blood flow.
  

Evaluation by a specialized physician, which involves reviewing the patient’s medical history and conducting various physical examinations. These examinations typically include measuring blood pressure, checking lipid levels such as cholesterol, and performing an electrocardiogram (ECG) to assess heart function. The gathered information is then analyzed to identify the risk factors for developing atherosclerosis. Diagnosis can be made through two main methods:

• CAVI (Cardio Ankle Vascular Index) is a diagnostic tool for assessing the flexibility of the arteries from the heart to the ankles. A normal CAVI value is less than 8. If the index value is above 8, it indicates a risk of developing arterial stiffness.
• ABI (Ankle-Brachial Index) is a diagnostic method for detecting peripheral arterial disease. It involves measuring the blood pressure in the brachial artery (arm) and the ankle. The obtained values are then used to calculate the ABI ratio, which should ideally fall between 1.0 and 1.1. A value below 0.9 indicates arterial stiffness, which can lead to various cardiovascular complications. Both ABI and CAVI tests can help in the early detection of heart disease, stroke, and other related conditions associated with arterial stiffness, facilitating timely prevention and treatment strategies.