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water in a hose in winter? What happens when the water freezes? The hose becomes rigid. Arteries become similarly rigid when their contents solidify. Normally our arteries are muscular and flexible. With each surge of blood pumped by the heart, the arteries expand, allowing large amounts of blood to flow. A hardened artery no longer expands and flexes with each blood surge, thereby limiting how much blood it can accommodate. Each heartbeat is therefore less efficient (because less blood can flow through the arteries with each beat), and the heart must work even harder to get blood where it needs to go. It also has to pump the blood through debris lining the arteries. Talk about a double-whammy! In addition to the problems plaque causes along our artery walls, some- times sticky masses break free. These clots then travel throughout the blood- stream and can lodge in arteries elsewhere in the body, blocking blood flow. The result can be a stroke, heart attack, or embolism , all of which can be devastating. Coronary artery disease develops gradually, but make no mistake: it is deadly. The good news, however, is that by losing even five percent of excess fat, by reducing saturated fats , trans-fatty acids , and cholesterol in one’s diet, and by getting regular exercise, a person can lower or even elimi- nate her risk of developing the disease. For those already diagnosed with coronary artery disease, a variety of treatment options exist. Noninvasive treatments include what we just men- tioned: losing weight and restoring BMI to 25 or lower; limiting saturated fats and cholesterol intake; and getting regular, sustained aerobic exercise. Invasive treatments include various medications to control cholesterol and break up plaque deposits, catheter -based procedures like balloon angio- plasty in which a tiny object is inserted into the artery and then expanded to open a clogged passageway, and heart surgery like bypass procedures in which arteries from other parts of the body are inserted to create a “detour” around a blocked passageway. Whatever the means, any blockage must be removed or bypassed or the condition can prove fatal.

The Silent Killer: High Blood Pressure and Heart Disease / 51