Atherosclerosis

Atherosclerosis is a disease in which plaque builds up inside your arteries.

Atherosclerosis can lead to serious problems, including

  • Coronary artery disease. These arteries supply blood to your heart. When they are blocked, you can suffer angina or a heart attack.
  • Carotid artery disease. These arteries supply blood to your brain. When they are blocked you can suffer a stroke.
  • Peripheral arterial disease. These arteries are in your arms, legs and pelvis. When they are blocked, you can suffer from numbness, pain and sometimes infections.

Atherosclerosis usually doesn't cause symptoms until it severely narrows or totally blocks an artery. Many people don't know they have it until they have a medical emergency.

A physical exam, imaging, and other diagnostic tests can tell if you have it. Medicines can slow the progress of plaque buildup. Your doctor may also recommend procedures such as angioplasty to open the arteries, or surgery on the coronary or carotid arteries. Lifestyle changes can also help. These include following a healthy diet, getting regular exercise, maintaining a healthy weight, quitting smoking, and managing stress.

 

Taking action to control your risk factors can help prevent or delay atherosclerosis and its related diseases. Your risk for atherosclerosis increases with the number of risk factors you have.

One step you can take is to adopt a healthy lifestyle, which can include:

  • Heart-Healthy Eating. A heart-healthy diet is low in sodium, added sugar, solid fats, and refined grains.  
  • Physical Activity. Physical activity can improve your fitness level and your health.
  • Quit Smoking. Smoking can damage and tighten blood vessels and raise your risk for atherosclerosis.
  • Weight Control. If you’re overweight or obese, work with your doctor to create a reasonable weight-loss plan.

Other steps that can prevent or delay atherosclerosis include knowing your family history of atherosclerosis. If you or someone in your family has an atherosclerosis-related disease, be sure to tell your doctor.

The exact cause of atherosclerosis isn't known. However, certain traits, conditions, or habits may raise your risk for the disease.

You can control most risk factors and help prevent or delay atherosclerosis, other risk factors can't be controlled.

  • Unhealthy blood cholesterol levels. This includes high bad cholesterol and low good cholesterol.
  • High blood pressure. Blood pressure is considered high if it stays at or above 140/90 mmHg over time.
  • Smoking. Smoking can damage and tighten blood vessels, raise cholesterol levels, and raise blood pressure. Smoking also doesn't allow enough oxygen to reach the body's tissues.
  • Diabetes.
  • Overweight or obesity.
  • Lack of physical activity. A lack of physical activity can worsen other risk factors for atherosclerosis, such as unhealthy blood cholesterol levels, high blood pressure, diabetes, and overweight and obesity.
  • Unhealthy diet. An unhealthy diet can raise your risk for atherosclerosis. Foods that are high in saturated and trans fats, cholesterol, sodium (salt), and sugar can worsen other atherosclerosis risk factors.
  • Older age. As you get older, your risk for atherosclerosis increases.
  • Family history of early heart disease. Your risk for atherosclerosis increases if your father or a brother was diagnosed with heart disease before 55 years of age, or if your mother or a sister was diagnosed with heart disease before 65 years of age.

The exact cause of atherosclerosis isn't known. However, studies show that atherosclerosis is a slow, complex disease that may start in childhood. It develops faster as you age.

Atherosclerosis may start when certain factors damage the inner layers of the arteries.

These factors include:

  • Smoking
  • High amounts of certain fats and cholesterol in the blood
  • High blood pressure
  • High amounts of sugar in the blood due to insulin resistance or diabetes

Plaque may begin to build up where the arteries are damaged. Over time, plaque hardens and narrows the arteries. Eventually, an area of plaque can rupture.

When this happens, blood cell fragments called platelets stick to the site of the injury. They may clump together to form blood clots. Clots narrow the arteries even more, limiting the flow of oxygen-rich blood to your body.

Atherosclerosis usually doesn't cause signs and symptoms until it severely narrows or totally blocks an artery. Many people don't know they have the disease until they have a medical emergency, such as a heart attack or stroke.

Some people may have signs and symptoms of the disease. Signs and symptoms will depend on which arteries are affected.

 

Your doctor will diagnose atherosclerosis based on your medical and family histories, a physical exam, and test results.

During the physical exam, your doctor may listen to your arteries for an abnormal whooshing sound called a bruit. Your doctor can hear a bruit when placing a stethoscope over an affected artery. A bruit may indicate poor blood flow due to plaque buildup.

Your doctor also may check to see whether any of your pulses (for example, in the leg or foot) are weak or absent. A weak or absent pulse can be a sign of a blocked artery.

Your doctor may recommend one or more tests to diagnose atherosclerosis. These tests also can help your doctor learn the extent of your disease and plan the best treatment.

Treatments for atherosclerosis may include heart-healthy lifestyle changes, medicines, and medical procedures or surgery.

Your doctor may recommend heart-healthy lifestyle changes if you have atherosclerosis. Heart-healthy lifestyle changes include heart-healthy eating, maintaining a healthy weight, managing stress, physical activity and quitting smoking.

Your doctor may recommend heart-healthy eating, which should include:

  • Fat-free or low-fat dairy products
  • Fish high in omega-3 fatty acids about twice a week
  • Fruits
  • Legumes
  • Vegetables
  • Whole grains

Try to limit alcohol intake. Too much alcohol will raise your blood pressure and triglyceride levels, a type of fat found in the blood. Alcohol also adds extra calories, which may cause weight gain.

Maintaining a healthy weight is important for overall health and can lower your risk for coronary heart disease. 

Regular physical activity can lower many atherosclerosis risk factors, including LDL or “bad” cholesterol, high blood pressure, and excess weight. Physical activity also can lower your risk for diabetes and raise your HDL or “good” cholesterol, which helps prevent atherosclerosis.

If you smoke or use tobacco, quit. Smoking can damage and tighten blood vessels and raise your risk for atherosclerosis.

Sometimes lifestyle changes alone aren’t enough to control your cholesterol levels. For example, you also may need statin medications to control or lower your cholesterol. By lowering your blood cholesterol level, you can decrease your chance of having a heart attack or stroke.

If you have severe atherosclerosis, your doctor may recommend a medical procedure or surgery.

Improved treatments have reduced the number of deaths from atherosclerosis-related diseases. These treatments also have improved the quality of life for people who have these diseases.

Adopting a healthy lifestyle may help you prevent or delay atherosclerosis and the problems it can cause. This, along with ongoing medical care, can help you avoid the problems of atherosclerosis and live a long, healthy life.