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Is there a self synthesized substance in the body, or a mechanism that can break down plaque in arteries ?

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  • $\begingroup$ Could you elaborate the question and make it more specific? There is a mechanism of thrombolysis and fibrinolysis if that i what you are asking for. en.wikipedia.org/wiki/Fibrinolysis and en.wikipedia.org/wiki/Thrombolysis $\endgroup$ – Polisetty Jul 21 '16 at 12:34
  • $\begingroup$ @Polisetty , I mean a mechanism to clean plaque buildup on arteries, i will edit the question. $\endgroup$ – soundslikefiziks Jul 21 '16 at 15:31
  • $\begingroup$ @Polisetty The links were helpful too, but i understand that it only deals with blood clots. $\endgroup$ – soundslikefiziks Jul 21 '16 at 15:33
  • $\begingroup$ Unlike the clots, plaques are a part of the pathological endothelium and actually cant be cleaned as such. Though, the cholesterol can be drained out by HDLs. By intervention, balloon angioplasty and the like can clean it up partially. So, again the answer differs based on what you're looking for. $\endgroup$ – Polisetty Jul 21 '16 at 23:26
  • $\begingroup$ @Polisetty So in that case, i guess the answer could be an elaboration on the "cholesterol can be drained out by HDLs" part. $\endgroup$ – soundslikefiziks Jul 22 '16 at 4:54
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Atherosclerosis can be reversed to some extent by certain diets and change in life style that result in decrease of excessive weight, blood pressure and cholesterol levels.

Studies

1) Dietary Intervention to Reverse Carotid Atherosclerosis (Circulation, 2010)

In a study in Israel, in 140 participants, who were mostly age 40-65 and overweight, they observed an average of 5% reduction of the the volume of the carotid artery wall, which reflects the reduction of the plaque.

Two-year weight loss diets can induce a significant regression of measurable carotid VWV [vessel wall volume]. The effect is similar in low-fat, Mediterranean, or low-carbohydrate strategies and appears to be mediated mainly by the weight loss–induced decline in blood pressure.

2) Intensive Lifestyle Changes for Reversal of Coronary Heart Disease (JAMA, 1998)

Forty-eight patients with moderate to severe coronary heart disease were randomized to an intensive lifestyle change group (10% fat whole foods vegetarian diet, aerobic exercise, stress management training, smoking cessation, group psychosocial support) or to a usual-care control group, and 35 completed the 5-year follow-up quantitative coronary arteriography.

Experimental group patients (20 [71%] of 28 patients completed 5-year follow-up) made and maintained comprehensive lifestyle changes for 5 years, whereas control group patients (15 [75%] of 20 patients completed 5-year follow-up) made more moderate changes. In the experimental group, the average percent diameter stenosis at baseline decreased 1.75 absolute percentage points after 1 year (a 4.5% relative improvement) and by 3.1 absolute percentage points after 5 years (a 7.9% relative improvement). In contrast, the average percent diameter stenosis in the control group increased by 2.3 percentage points after 1 year (a 5.4% relative worsening) and by 11.8 percentage points after 5 years (a 27.7% relative worsening) (P=.001 between groups. Twenty-five cardiac events occurred in 28 experimental group patients vs 45 events in 20 control group patients during the 5-year follow-up (risk ratio for any event for the control group, 2.47 [95% confidence interval, 1.48-4.20]).

The experimental group reduced LDL cholesterol levels by 40% at 1 year and by 20% after 5 years.

When we began this study, we believed that the younger patients with milder disease would be more likely to show regression, but we did not find this to be true. Instead, we found that the primary determinant of change in percent diameter stenosis in the experimental group was neither age nor disease severity but adherence to the recommended changes in diet and lifestyle.

those who gained weight were more likely to show progression of atherosclerosis.

Experimental group patients had a 91% reduction in reported frequency of angina after 1 year and a 72% reduction after 5 years (Table 5). In contrast, control group patients had a 186% increase in reported frequency of angina after 1 year and a 36% decrease in frequency after 5 years.

Mechanisms

Reversal of atherosclerotic plaques can be achieved by removing the causes. According to Atherosclerosis: Process, Indicators, Risk Factors and New Hopes, (Int J Prev Med, 2014), decreasing excessive body weight + exercise + cholesterol-lowering diet + cessation of smoking can result in:

  • Less damage to the arterial intima
  • Higher HDL/LDL ratio, meaning adequate removal of LDL (by HDL) from the blood into the liver and thus less deposition of cholesterol into the arteries
  • Less inflammation in the arterial intima
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