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Non-atheromatous arteriosclerosis: causes, symptoms, diagnosis, treatment
Last reviewed: 07.07.2025
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Non-atheromatous arteriosclerosis is an age-related fibrosis of the aorta and its main branches.
Nonatheromatous arteriosclerosis causes intimal thickening and weakens and destroys the elastic components. The smooth muscle layer (middle vascular layer) atrophies, and the lumen of the affected artery widens (ectasia occurs), leading to the development of aneurysm or dissection. Arterial hypertension is the main factor in the development of aortic arteriosclerosis and aneurysm. Intimal damage, ectasia, and ulceration may lead to thrombosis, embolism, or complete occlusion of the artery.
Arteriolosclerosis affects distal arteries in patients with diabetes mellitus or hypertension. Hyaline arteriolosclerosis affects small arteries and arterioles in diabetes mellitus. Typically, hyaline thickening occurs, the arteriolar wall degrades, and the lumen narrows, causing diffuse ischemia, especially in the kidneys. Hyperplastic arteriolosclerosis develops more often in patients with hypertension; it is typical to develop extensive concentric thickening and narrowing of the lumen, sometimes with fibrin deposits and necrosis of the vascular wall (necrotizing arteriolitis). Hypertension increases these changes, and arteriosclerosis (due to increased arteriolar rigidity and increased peripheral resistance) may contribute to the maintenance of hypertension.
Mönckeberg's arteriosclerosis (calcific sclerosis of the media) develops in patients over 50 years of age. Age-related degeneration of the media occurs with foci of calcification and even bone formation within the arterial wall. Arterial sections may become a hard calcified tube without narrowing of the lumen.
The diagnosis is usually obvious from a simple X-ray examination. The clinical significance of this disease is only that the artery is unable to respond by changing its lumen, which leads to a marked but false increase in blood pressure figures when it changes.
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