What Is Atherosclerosis?

Your arteries are the blood vessels that carry oxygen-rich blood from your heart to the rest of your body. When they narrow and stiffen due to plaque buildup, they can restrict blood flow to various organs and tissues, potentially causing symptoms and even tissue damage.

Many people with atherosclerosis don’t experience any symptoms, especially if their case is mild. But symptoms can occur in areas of the body where narrowed or stiffened arteries aren’t delivering enough blood.

The most common symptoms of atherosclerosis happen when blood flow is restricted to your heart, brain, limbs, or kidneys.

• Chest pain (angina)
• Shortness of breath
• Abnormal heartbeat
• Confusion
• Dizziness
• Sudden and severe headache
• Numbness, weakness, or pain in the arms or legs
• Leg pain while walking (claudication)
• High blood pressure (hypertension)
• Loss of appetite
• Nausea

The exact causes of atherosclerosis aren’t known.

• Smoking or exposure to secondhand smoke
• High levels of fat or low-density lipoprotein (LDL) cholesterol in your blood
• High blood pressure (hypertension)
• Elevated blood sugar
• Inflammation from arthritis, lupus, infection, or other diseases, measured by C-reactive protein levels in your blood

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• Diabetes (type 1 and type 2)
• Being overweight or having obesity
• Lack of physical activity
• Unhealthy diet
• Family history of heart disease
• Older age (age 45 or older in men, and age 55 or older in women)

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To diagnose atherosclerosis, your doctor will consider your symptoms and medical history, perform a physical exam, and order tests.

• Blood tests: If you have diabetes, prediabetes, or symptoms of them, your doctor may check your blood cholesterol and triglyceride levels, as well as blood glucose (sugar).
• Blood-pressure measurements: Your doctor may take your blood pressure at various points on your arms or legs to help measure blood flow and detect blockages. This may include use of a special ultrasound device called a Doppler ultrasound. The blood pressure in your ankle may be compared with the blood pressure in your arm in a test called the ankle-brachial index (ABI).
• Coronary angiogram: A long, narrow tube called a catheter is inserted through an artery and extended to your heart, then injected with a dye that’s visible on X-ray images to reveal blockages in your coronary arteries.
• Electrocardiogram (ECG or EKG): This test measures the electrical activity in your heart and may reveal a heart rhythm disorder or a prior heart attack.
• Exercise stress test: This will usually include riding a stationary bike or using a treadmill so your physician can monitor changes in your blood pressure.
• Echocardiogram: Often paired with exercise tests, this test measures sound waves to show how your heart is moving and how blood is flowing through it.
• Coronary calcium scan: In this test, X-ray images are used to spot calcium deposits in arteries that may be prohibiting blood flow.

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• Imaging tests: Other tests may include magnetic resonance angiography (MRA) or positron emission tomography (PET), both of which help doctors visualize plaque buildup in the arteries.

The treatment that your doctor recommends for atherosclerosis will depend on its severity and which arteries are affected. Treatment for the condition may be especially critical if blood flow to the heart or brain is substantially restricted.

Your healthcare provider may first recommend lifestyle changes, which can help even if you need other treatments.

Medication Options

Drug treatments for atherosclerosis can lower your blood pressure, improve unhealthy cholesterol levels, and reduce your risk of developing dangerous blood clots.

• Cholesterol medications: These drugs, which include statins and fibrates, are designed to lower your levels of total and LDL (“bad”) cholesterol.
• Antiplatelet medications: These blood-thinning drugs, including aspirin, reduce your risk of developing a dangerous blood clot that could block an artery.
• Blood pressure medications: These drugs, some of which may also relieve chest pain, include beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, calcium channel blockers, and diuretics.
• Pain medications: If you experience leg or joint pain with activity, your doctor may advise you to take an over-the-counter pain reliever or prescribe something stronger.

Surgery

• Angioplasty and stent placement: This procedure involves opening a blocked section of an artery by inflating a tiny balloon and inserting a stent, a mesh tube that’s left in place to hold the artery open.
• Endarterectomy: This refers to removing plaque deposits from the artery wall. It’s usually reserved for the most severe cases, and not everyone may be a viable candidate for it.

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• Bypass surgery: In this procedure, doctors graft a section of blood vessel from another area of your body around a blocked or narrowed artery.
• Fibrinolytic therapy: Also known as thrombolytic therapy, this involves the injection of medication through an IV or catheter to break up blood clots. It’s typically used only in emergencies.

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Complementary and Integrative Treatments

• Alpha-linolenic acid (ALA), which can be found in flaxseeds, walnuts, and various oils

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• Barley
• Blond psyllium
• Cocoa
• Fish oil
• Folic acid
• Garlic
• Green tea
• Oat bran

Talk to your doctor before starting any supplement or making dietary changes.

Healthy lifestyle choices are an important part of preventing atherosclerosis. Examples include:

• Don’t smoke, or quit if you do.

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• Get 30 minutes of moderate aerobic exercise most days of the week.

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• Follow a heart-healthy diet based on fruits, vegetables, whole grains, lean protein, and healthy fats.

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• Lose any extra weight.

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• Manage stress, which can help lower your blood pressure and reduce atherosclerosis risks.

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With treatment, however, the progress of atherosclerosis can be halted, and plaque buildup can be removed.

• Coronary artery disease (CAD): Coronary artery disease is caused by plaque buildup in the heart and can lead to chest pain (angina), heart failure, or a heart attack.
• Carotid artery disease: This occurs when blood flow to the neck, spine, and brain is restricted. It can cause a transient ischemic attack (TIA) or a stroke.
• Chronic kidney disease: When atherosclerosis narrows the arteries leading to your kidneys, they can no longer sufficiently filter waste in your body.
• Peripheral artery disease: When atherosclerosis narrows the arteries in your arms or legs, you may develop this type of circulation problem that can cause affected limbs to lose sensation or hurt with movement.
• Aneurysm: An aneurysm is a bulge in your artery wall. This serious complication can occur anywhere in your body and may cause throbbing pain or internal bleeding, both of which are medical emergencies.

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Atherosclerosis increases the risk of developing several health problems, including the following:

• Coronary artery disease
• Carotid artery disease
• Chronic kidney disease
• Peripheral artery disease
• Aneurysm

Atherosclerosis may be caused or made worse by certain health conditions, including these:

• High cholesterol
• High blood pressure
• Diabetes and prediabetes
• Obesity or being overweight

• Atherosclerosis occurs when plaque builds up in the artery walls and restricts blood flow to various parts of the body.
• When atherosclerosis causes our arteries to narrow and stiffen, it can lead to serious cardiovascular issues, including heart disease.
• Risk factors for atherosclerosis include high cholesterol, high blood pressure, smoking, diabetes, obesity, and a lack of physical activity. Plaque buildup worsens gradually as we age, so atherosclerosis can remain symptom-free until middle age.
• Your doctor may recommend lifestyle changes and medications to reduce cholesterol, thin the blood, and reduce pain, in addition to surgery, in severe cases.