Atherosclerosis
Plaque buildup that narrows and hardens the arteries
Quick Facts
- Type: Cardiovascular (blood vessel) condition
- Key feature: Plaque buildup inside artery walls
- Major risks: Heart attack, stroke, peripheral artery disease
- Main drivers: High cholesterol, high blood pressure, smoking
Overview
Atherosclerosis is a slow, progressive process in which fatty deposits, cholesterol, calcium, and other substances build up inside the walls of arteries, forming patches called plaque. Over time, plaque narrows the arteries and makes them stiffer, reducing the flow of oxygen-rich blood to the heart, brain, and other organs.
Atherosclerosis usually develops silently over many years and is the underlying cause of most heart attacks and strokes. A plaque can also rupture, triggering a blood clot that suddenly blocks an artery. The good news is that the process can often be slowed, and risk reduced, through lifestyle changes and treatment of the conditions that drive it.
Symptoms
Atherosclerosis often causes no symptoms until an artery becomes significantly narrowed or blocked. Symptoms then depend on which arteries are affected:
- Heart arteries: Chest pain or pressure (angina), especially with exertion, and shortness of breath.
- Brain arteries: Sudden weakness, numbness, trouble speaking, or vision changes, which can signal a stroke or warning stroke.
- Leg arteries: Leg pain or cramping when walking, poor wound healing, or cold feet.
- Kidney arteries: High blood pressure that is hard to control.
Sudden, severe chest pain, or stroke-like symptoms, require emergency care.
Causes
Atherosclerosis is thought to begin with damage to the inner lining of an artery. Contributing factors include:
- High cholesterol: Excess LDL ("bad") cholesterol contributes to plaque formation.
- High blood pressure: Increased pressure damages artery walls over time.
- Smoking: Tobacco chemicals injure blood vessels and speed plaque buildup.
- High blood sugar: Diabetes accelerates artery damage.
- Inflammation: Ongoing inflammation in the body can promote plaque growth.
Once the lining is damaged, cholesterol and cells collect at the site and gradually form plaque.
Risk Factors
- High LDL cholesterol or low HDL cholesterol
- High blood pressure
- Smoking or tobacco use
- Diabetes or insulin resistance
- Obesity and physical inactivity
- An unhealthy diet high in saturated fats
- Older age and a family history of heart disease
Diagnosis
Doctors assess overall risk and look for narrowed arteries:
- Risk assessment: Reviewing blood pressure, cholesterol, blood sugar, and family history.
- Blood tests: Checking cholesterol and blood sugar levels.
- Imaging and other tests: Ultrasound, CT, stress testing, or angiography to evaluate blood flow and detect blockages when needed.
Treatment
Treatment aims to slow plaque buildup, lower the risk of clots, and treat blockages.
- Lifestyle changes: A heart-healthy diet, regular exercise, quitting smoking, and weight management are the foundation of care.
- Medications: Statins and other drugs to lower cholesterol, medicines to control blood pressure and blood sugar, and sometimes low-dose aspirin to reduce clotting risk.
- Procedures: For severe blockages, procedures such as angioplasty with a stent, or bypass surgery, may restore blood flow.
Managing the conditions that drive atherosclerosis is key to preventing heart attacks and strokes.
Prevention
- Eat a diet rich in vegetables, fruits, whole grains, and healthy fats, and low in saturated and trans fats
- Be physically active most days of the week
- Do not smoke, and avoid secondhand smoke
- Keep blood pressure, cholesterol, and blood sugar in healthy ranges
- Maintain a healthy weight
- Limit alcohol and manage stress
When to See a Doctor
See a doctor to have your blood pressure, cholesterol, and blood sugar checked, especially if you have risk factors or a family history of heart disease. Call emergency services immediately for signs of a heart attack (chest pain or pressure, pain spreading to the arm or jaw, shortness of breath, cold sweat) or stroke (sudden face drooping, arm weakness, or speech difficulty). Fast treatment saves heart and brain tissue.
Frequently Asked Questions
Can atherosclerosis be reversed?
Atherosclerosis usually cannot be fully reversed, but its progression can be slowed and risk greatly reduced. Lowering cholesterol and blood pressure, quitting smoking, and adopting a healthy lifestyle can stabilize plaque and lower the chance of heart attack and stroke.
What are the warning signs of atherosclerosis?
It often causes no symptoms until an artery is significantly narrowed. Then signs depend on location, such as chest pain with exertion, leg pain when walking, or stroke-like symptoms. Sudden severe chest pain or stroke symptoms require emergency care.
How is atherosclerosis treated?
Treatment combines lifestyle changes with medications such as statins and blood pressure drugs. For severe blockages, procedures like angioplasty with a stent or bypass surgery may be needed to restore blood flow.
What causes plaque to build up in arteries?
Plaque forms when the artery lining is damaged by factors such as high cholesterol, high blood pressure, smoking, and high blood sugar. Cholesterol and cells then collect at the site and gradually harden into plaque.
How can I lower my risk of atherosclerosis?
Eat a heart-healthy diet, exercise regularly, avoid smoking, and keep blood pressure, cholesterol, and blood sugar under control. Maintaining a healthy weight and limiting alcohol also help protect your arteries.
References
- National Heart, Lung, and Blood Institute (NHLBI). Atherosclerosis.
- Mayo Clinic. Arteriosclerosis / atherosclerosis — Symptoms and causes.
- MedlinePlus, U.S. National Library of Medicine. Atherosclerosis.
- American Heart Association. Atherosclerosis.