What Is Atherosclerosis? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Atherosclerosis is the buildup of plaque — a combination of cholesterol, fat, calcium, and blood elements — on and inside the walls of your arteries. (1)

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, blood flow to various organs and tissues can be restricted, potentially causing symptoms and even tissue damage.

The terms “atherosclerosis” and “arteriosclerosis” are often used interchangeably, but atherosclerosis is actually a form of arteriosclerosis (commonly known as hardening of the arteries) specifically caused by plaque buildup.

Atherosclerosis can affect any of the body’s arteries. When the arteries that lead to your heart are affected, the condition is known as coronary artery disease (CAD). (2,3)

The exact causes of atherosclerosis aren’t known.

There’s evidence that it may be caused by damage to the inner lining of your arteries (known as the endothelium), where plaque typically accumulates.

This damage may be caused by the following factors:

• Smoking and other tobacco use
• High levels of fat or cholesterol in your blood
• High blood pressure (hypertension)
• Elevated blood sugar
• Inflammation from arthritis, lupus, infection, or other diseases (3)

Risk factors for atherosclerosis include the following health conditions:

• High levels of LDL (“bad”) cholesterol
• Low levels of HDL (“good”) cholesterol
• High blood pressure
• Tobacco use
• Diabetes or prediabetes
• Being overweight or obese
• Lack of physical activity
• An unhealthy diet
• A family history of heart disease
• Older age (3,4)

In men, the risk for atherosclerosis increases after age 45. In women, the risk increases after age 55.

Your risk for atherosclerosis is higher if your father or a brother was diagnosed with heart disease before age 55, or if your mother or a sister was diagnosed with heart disease before age 65.

In addition, recent research suggests that high levels of a protein called C-reactive protein (CRP) in your blood may increase your risk for atherosclerosis. CRP is a marker of inflammation in your body. (4)

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

Commonly used tests to help diagnose atherosclerosis include:

Blood Tests Your doctor may check your blood cholesterol and triglyceride levels, as well as blood glucose (sugar) if diabetes or prediabetes is known or suspected.

Blood Pressure Measurements Your doctor may take your blood pressure at various points on your arms or legs, which can help measure blood flow and detect blockages. A special ultrasound device (Doppler ultrasound) may be used for this.

Coronary Angiogram This test involves inserting a long, narrow tube (catheter) through an artery and extending it to your heart, then injecting 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. (3)

Learn More About Diagnosing Atherosclerosis

Prognosis of Atherosclerosis

Atherosclerosis is a serious health condition that may lead to major problems like heart failure, heart attack, or stroke. But it develops at a different pace in different people.

If your atherosclerosis progresses very slowly over decades and stays mild, you may never develop any symptoms or health problems as a result.

But if your atherosclerosis progresses more quickly and becomes moderate or severe, you may experience disabling complications or premature death.

How quickly your atherosclerosis develops or progresses depends on several risk factors, including many related to your lifestyle. (1,3)

The course of treatment that your doctor recommends for atherosclerosis will depend on how severe it is and which arteries are affected.

Treatment for the condition may be especially critical if blood flow to the heart or brain is substantially restricted.

Proven treatments for atherosclerosis include lifestyle measures, prescription drugs, and surgical procedures.

Lifestyle changes are often the first recommended treatment and are likely to help even if you need other treatments.

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

Surgery is usually recommended only if your condition is especially severe or if you don’t respond well to drug treatments. (2,3)

Medication Options

Your doctor may prescribe drugs to treat different causes or effects of your atherosclerosis:

Cholesterol Medications These drugs, which include statins and fibrates, are designed to lower your levels of total and LDL (“bad”) cholesterol.

Antiplatelet Medications These 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 pain with activity, your doctor may advise you to take an over-the-counter pain reliever or prescribe something stronger. (3)

Alternative and Complementary Therapies

Changing your lifestyle is an important part of addressing atherosclerosis. Important changes may include:

• Getting more aerobic exercise
• Following a heart-healthy diet
• Losing extra weight
• Managing stress
• Not smoking (1,3)

A number of different foods and dietary supplements may also help lower your cholesterol or blood pressure, including the following (talk to your doctor before taking any supplement):

• Alpha-linolenic acid (ALA)
• Barley
• Black or green tea
• Calcium
• Cocoa
• Cod liver oil
• Coenzyme Q10
• Fish oil
• Folic acid
• Garlic
• Oat bran
• Psyllium (3)

Related

9 Scientific Benefits of Following a Plant-Based Diet

Surgical Procedures

If lifestyle measures and medication aren’t enough to improve your symptoms, or if your atherosclerosis is advanced, your doctor may recommend one or more of the following procedures:

Angioplasty and Stent Placement This procedure involves opening up 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 procedure involves surgically removing plaque deposits from the artery wall. This may be done in the carotid arteries of your neck.

Fibrinolytic Therapy Your doctor may use a clot-dissolving drug at the site of an acute blood clot to break it up.

Bypass Surgery In this surgical procedure, doctors graft a section of blood vessel from another area of your body around a blocked or narrowed artery. (2,3)

Learn More About Treatment for Atherosclerosis

Prevention of Atherosclerosis

If your atherosclerosis is still at an early stage or if you haven’t been diagnosed with the condition yet, lifestyle measures can go a long way toward preventing plaque from forming in your arteries. These include:

• Not smoking
• Following a heart-healthy diet
• Getting enough aerobic exercise
• Maintaining a healthy weight (3)

Not smoking is probably the most important factor in limiting your risk, followed by diet and physical activity.

A heart-healthy diet is based on fruits and vegetables, whole grains, lean protein sources, and healthy fats. It’s important to limit sodium, refined carbohydrates, and saturated and trans fats.

Getting enough exercise generally means 30 minutes of moderate aerobic activity most days of the week. But more exercise yields more benefits, and some is better than none at all.

Losing excess weight can help improve your cholesterol levels. If you’re overweight, losing just 10 percent of your body weight can make a substantial difference, according to the American Heart Association. (1,3)

Learn More About Preventing Atherosclerosis

Subclinical atherosclerosis — the kind that doesn’t have any symptoms — appears to be common, with one study in the central Appalachian region of the United States showing that 56 percent of adults had a coronary artery calcium score (a measure of atherosclerosis) greater than zero. (5)

Heart disease, which commonly results from atherosclerosis, kills about 647,000 people in the United States each year, according to the Centers for Disease Control and Prevention (CDC). That’s 1 out of 4 total deaths, and makes heart disease the leading cause of death among women, men, and most racial and ethnic groups. (6)

According to the American Heart Association, more than 360,000 people in the United States die annually as a result of CAD, making it the deadliest form of heart disease. Other leading cardiovascular causes of death are also connected to atherosclerosis, including stroke, heart failure, and high blood pressure. (5)

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

• Coronary artery disease (CAD)
• Carotid artery disease
• Chronic kidney disease
• Peripheral artery disease
• Aneurysm (3)

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

• High cholesterol
• High blood pressure
• Diabetes and prediabetes
• Overweightness and obesity (3,4)

The following organizations and websites offer information about atherosclerosis, along with ways to access care and connect with other people.

American Heart Association (AHA)

The leading advocacy and research group for heart health in the United States, the AHA provides information on different types of heart disease, ideas to inspire healthy living, and guidance on how to deal with a heart-related event or emergency.

National Heart, Lung, and Blood Institute (NHLBI)

This research arm of the U.S. National Institutes of Health provides an overview of topics connected to atherosclerosis and associated health conditions. It also has information and links about participating in atherosclerosis-related clinical trials.

Centers for Disease Control and Prevention (CDC)

This page from the main U.S. public health agency gives facts and statistics on heart disease, including charts and maps that show the racial and ethnic and geographic distribution of heart-related outcomes.

Mayo Clinic

This page provides information on all aspects of atherosclerosis, from how to limit your risk to finding the right health professionals when you need care.

Additional reporting by Quinn Phillips.