Arterial calcification is the accumulation of calcium in the artery walls, leading to their hardening and loss of flexibility. This progressive condition is an indicator of potential cardiovascular disease and is influenced by a combination of underlying health conditions and lifestyle factors.
How Calcium Builds Up in Arteries
The buildup of calcium in arteries is an active, regulated process, not simply a passive deposition of dietary calcium. It begins with injury or inflammation to the artery’s inner lining, caused by factors like high cholesterol or smoking. This damage triggers a transformation of vascular smooth muscle cells (VSMCs) within the artery wall.
These VSMCs, which normally help regulate blood vessel tone, begin to behave like bone-forming cells. They secrete proteins and form tiny structures called matrix vesicles, which act as sites for calcium and phosphate crystals to form and grow.
This process results in hard, mineralized deposits within the vessel wall. Over time, these small microcalcifications can merge into larger deposits, leading to the stiffening of the arteries, a condition known as arteriosclerosis.
Key Risk Factors for Calcification
Risk factors for arterial calcification are both non-modifiable and modifiable. Non-modifiable factors include advancing age, as calcification naturally progresses over time, and a person’s genetic background.
Modifiable risks are largely related to lifestyle. Smoking is a prominent contributor, as is a diet high in processed foods and unhealthy fats. These habits can initiate the inflammatory processes that lead to calcification.
Certain medical conditions also increase risk. Chronic kidney disease (CKD) is a major factor because it disrupts the body’s balance of calcium and phosphate. Diabetes, high cholesterol, and hypertension also contribute by damaging blood vessels or causing the initial injury to arterial walls.
Connection to Heart Disease and Stroke
Arterial calcification impacts the cardiovascular system by making arteries stiff. This stiffness forces the heart to work harder to pump blood, which can increase blood pressure and strain the heart muscle over time. This can lead to left ventricular hypertrophy, a condition where the heart’s main pumping chamber thickens.
The reduced flexibility also impairs the arteries’ ability to expand and contract with each heartbeat. This can decrease blood flow to the heart muscle itself, particularly during the diastolic phase when the heart rests, potentially causing ischemia.
The presence of calcium within atherosclerotic plaques increases the risk of heart attacks and strokes. While calcification can sometimes stabilize a plaque, it can also make it brittle and prone to rupture. A rupture triggers the formation of a blood clot that can block the artery, cutting off blood flow to the heart or brain.
Diagnosis Through Imaging and Scoring
Arterial calcification is diagnosed and quantified using a non-invasive coronary artery calcium (CAC) scan. This specialized computed tomography (CT) scan captures detailed images of the heart, allowing doctors to measure calcified plaque in the coronary arteries without using contrast dye.
The result is a numerical value known as the Agatston score. A score of zero indicates no detectable calcification and a very low risk of future cardiovascular events. The score reflects the total volume and density of calcium deposits.
Higher scores indicate a greater plaque burden and increased risk. A score of 1-100 suggests a mild burden, 101-400 indicates moderate accumulation, and a score above 400 signifies extensive plaque. This score helps guide preventative treatment but does not measure artery blockage.
Management Strategies
Management focuses on slowing the progression of calcification and reducing cardiovascular risks, as there are no treatments to reverse existing deposits. Lifestyle modifications are a primary approach. This includes adopting a heart-healthy diet, like the Mediterranean diet, to help manage underlying risk factors.
Regular physical activity helps improve cardiovascular health, control blood pressure, and maintain a healthy weight. Quitting smoking is also an important step, as it reduces injury to the arterial walls and lowers overall cardiovascular risk.
Medical interventions are often used alongside lifestyle changes. Medications to control high blood pressure and lower cholesterol, such as statins, are frequently prescribed to slow the progression of atherosclerosis. For those with chronic kidney disease or diabetes, carefully managing these conditions is necessary to lessen their impact on the vascular system.