Exercise as it relates to Disease/Effective treatment for atherosclerosis - Surgery vs Exercise

Prevalence
Atherosclerosis is a type of cardiovascular disease and is the top 10 causes of death worldwide. An estimated 92% of Australian adults had at least one of the nine risk factors with atherosclerosis being the most common cause of heart disease.

What is Atherosclerosis?
Atherosclerosis is a condition where the arteries become narrow and hardened due to an accumulation of lipids called plaque inside the artery wall. This process reduces or completely blocks blood flow around the body, posing serious cardiovascular implications.

Causes of Atherosclerosis
These comorbidities significantly increase the chances of atherosclerosis, and stem from risk factors such as
 * Slow, complex disease that may start in childhood and develops faster with age
 * Initiated by a damage occurring in the inner wall of an artery called the endothelium, overtime substances travelling in the blood such as cholesterol, fats and cellular waste products accumulate inside the damaged area of the artery wall
 * Can affect the entire artery tree, but mainly affects the larger high-pressure arteries

Effects of Atherosclerosis

 * Coronary Artery Disease (plaque rupture and clotting causing heart muscle to die)
 * Cerebrovascular Disease (plaque rupture in the brain's arteries cause’s strokes, with the potential for permanent brain damage)
 * Peripheral Artery Disease (narrowing in the arteries of the legs caused by plaque. This causes pain on walking and poor wound healing. Severe disease may lead to amputations)

Current Rehabilitation Methods

 * Appropriate pharmacological therapy
 * Modification of lifestyle (e.g. smoking cessation, balanced diet, stress management)
 * Appropriate exercise regime
 * Surgery - There are 2 major surgeries to treat atherosclerosis
 * 1. Stent Placement and Angioplasty (PCIs) - Inserting a tiny wire mesh tube and inflating a tiny balloon where the artery is clogged to help widen the artery
 * 2. Coronary Artery Bypass Graft Surgery (CABG) - Rerouting a healthier vessel onto a coronary artery bypassing the clogged artery

Exercise
Patients with major contraindications should not engage in physical activity without medical review prior commencing physical activity

Recommendations for Effective Exercise Rehabilitation
Recommended Activity from the National Heart Foundation of Australia
 * 30-45 min, preferably all days of the week of moderate-intensity physical activity using large muscle groups, such as walking, riding, or swimming
 * Volume of physical activity should be increased gradually over time

Improved Compliance

 * Involvement and support from friends and family
 * Positive mindset and an interest in physical activity which will lead to increased motivation
 * Physicians and patients must be equally committed to achieving set goals and should communicate instructions clearly and prescribe therapies that are effective, affordable, and have minimal or no adverse effects on patient quality of life