Atherosclerosis

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Overview

What is atherosclerosis?

Arteries are blood vessels that carry blood from your heart to the rest of your body. Atherosclerosis (say: “ath-er-o-skler-o-sis”) is a disease that causes your arteries to narrow and become hard. It is even possible for an artery to become completely blocked. Atherosclerosis may also be called atherosclerotic cardiovascular disease (ASCVD).

Causes and Risk Factors

What causes atherosclerosis?

Doctors don’t know exactly what causes atherosclerosis. It may first develop when the inner layers of your arteries become damaged. Many things can cause this damage, including:

  • High blood pressure
  • High cholesterol
  • Diabetes
  • Overweight or obesity
  • Smoking and tobacco use
  • Unhealthy diet
  • Lack of exercise
  • Family history of heart disease

When damage happens, your body tries to repair your arteries. The repair process creates plaque (say: “plak”) deposits on the walls of the arteries. Plaque is made of fat, cholesterol, calcium, and other things that are naturally found in your blood.

Over time, this plaque builds up in your arteries, becomes hard, and makes your arteries narrow. Sometimes, the plaque can burst. This causes a blood clot (also called a thrombus) to form. If this happens in an artery that carries blood to your heart, it can cause a heart attack. If it happens in an artery that carries blood to your brain, it can cause a stroke.

How do my cholesterol levels contribute to atherosclerosis?

Cholesterol is a waxy substance your body uses to protect nerves, make cell tissues, and produce certain hormones. Some cholesterol is essential for health. Your body (particularly your liver) can make all the cholesterol it needs. Your body also gets some cholesterol directly from the food you eat (such as eggs, meats, and dairy products).

The two most important types of cholesterol to know about are:

  1. Low-density lipoprotein (LDL), or “bad” cholesterol
  2. High-density lipoprotein (HDL), or “good” cholesterol

LDL cholesterol is the type of cholesterol that goes into making plaque. High levels of LDL cholesterol can damage your arteries and contribute to atherosclerosis. On the other hand, a high level of HDL cholesterol can actually help protect your arteries and prevent atherosclerosis.

Complications

How does atherosclerosis contribute to cardiovascular disease?

Atherosclerosis is the primary cause of cardiovascular disease. Cardiovascular disease is the leading cause of death in the United States. Types of cardiovascular disease include:

  • Coronary artery disease:Coronary artery disease happens when plaque builds up in the arteries that supply blood to your heart. When blood flow to your heart muscle slows down or when the arteries become blocked, it can cause chest pain and heart attack.
  • Small vessel disease:Small vessel disease happens when plaque builds up in the small blood vessels of your heart. This can weaken your heart and cause chest pain, especially during exercise.
  • Cerebrovascular disease and stroke:A stroke happens when an artery that carries blood to your brain becomes blocked. This can cause temporary or permanent brain damage. You may lose the ability to see, to speak, or to move parts of your body.
  • Peripheral arterial disease (PAD):PAD happens when plaque builds up in the arteries that supply blood to your arms or legs. This can cause numbness, pain, and possibly infection in your affected limb(s).

 

What other ways can atherosclerosis affect my body?

An aneurysm (say: “an-yur-izm”) is a weak area in a blood vessel that swells up like a balloon and becomes abnormally large. When this happens, the blood vessel can tear or burst. Atherosclerosis can cause one of the large arteries in your body to develop an aneurysm. For example, atherosclerosis can affect the large artery that carries blood from your heart to the rest of your body (called the aorta).

Atherosclerosis can affect the large arteries that carry blood to your intestines. These arteries can become so narrow that they do not provide enough blood for normal digestion. Atherosclerosis can also affect the large arteries that carry blood to your kidneys. This can contribute to kidney failure and high blood pressure.

Prevention

How can I prevent atherosclerosis?

An important way for you to prevent atherosclerosis is by making lifestyle changes. Lifestyle changes can lower your risk of atherosclerosis by helping you lose weight, lower LDL cholesterol, increase HDL cholesterol, and lower your blood pressure. They can also help control your blood sugar, which is important if you have diabetes.

If you are at higher risk for atherosclerosis, your doctor may recommend that you also take a medicine called a statin. Statins slow down your body’s production of cholesterol. They also remove cholesterol buildup from your arteries.

 

What lifestyle changes can help prevent atherosclerosis?

The following lifestyle changes will lower your risk of atherosclerosis:

  • Exercise can help you lose weight if you’re overweight or obese. It also helps raise your HDL cholesterol and lower your LDL cholesterol. Try to work up to an average of 40 minutes of moderate-to-vigorous physical activity, 3 to 4 times a week. Talk to your doctor before starting an exercise plan.
  • Quit smoking.Smoking can damage your blood vessels, reduce the flow of blood through blood vessels, and lower your HDL cholesterol. Even exposure to secondhand smoke can affect your blood vessels and cholesterol. Talk to your doctor about developing a plan to help you stop smoking.
  • Eat a heart-healthy diet.A heart-healthy diet includes a variety of fresh fruits and vegetables, whole grains, fish, lean meats, and “good” fats. A Mediterranean diet is a very heart-healthy diet.
  • Manage stress.Try to reduce your stress Ways to deal with stress include deep breathing and relaxation techniques, such as meditation and gentle exercise (for example, walking or yoga). Talking with a friend, family member, or health care professional may also be helpful.

Should I take a statin?

Your doctor has a way to calculate your risk of developing atherosclerosis based on your age, sex, cholesterol levels, blood pressure, and other factors. If you are at higher risk, your doctor may recommend that you take a statin.

What if lifestyle changes and/or a statin aren’t enough?

Your doctor may prescribe other medicines to lower your blood pressure or cholesterol levels and to prevent blood clots. For example, if you are 50 to 59 years of age and have a high risk for heart disease, your doctor may want you to take a low dose of aspirin each day. Aspirin helps keep your blood from forming clots that can clog your arteries. Do not start taking aspirin without talking to your doctor first.

If you have severe atherosclerosis or have been diagnosed with cardiovascular disease, your doctor may recommend a procedure to open your blocked arteries or surgery to bypass (go around) the blockage.

Questions

  • Am I at risk for atherosclerosis?
  • What changes can I make to reduce my risk?
  • Do I need any tests?
  • Do I have high cholesterol?
  • What is the likely cause of my atherosclerosis?
  • How much plaque has built up in my arteries?
  • How does my diet contribute to atherosclerosis?
  • Am I at risk for heart attack or other complications?
  • Do I need medicine? Surgery?

Citations

Other Organizations

American Heart Association