What Is Atherosclerosis?

Atherosclerosis is a narrowing of the arteries caused by a buildup of cholesterol plaque. It may lead to stroke, heart attacks, dementia, and other health challenges.

When plaque builds up and the arteries become hard and inflamed, blood has trouble flowing through them to the rest of the body. This prevents your organs and tissues from getting the oxygenated blood they need to function.

Atherosclerosis is preventable and treatable, although not reversible.

Atherosclerosis is a “silent” condition during its early stages, meaning it doesn’t usually manifest with any evident symptoms until a significant blood flow blockage occurs.

Once symptoms develop, these may include:

chest pain (stable angina)

pain in your leg, arm, and other regions supplied by the blocked artery

cramping in the buttocks while walking

shortness of breath

fatigue

mental confusion if the blockage affects circulation to your brain

weakness and loss of sensation on one side of the body (hemiparesis) if the blockage affects brain circulation

muscle weakness and cramps in your legs from lack of circulation

Read more on the signs of atherosclerosis.

Atherosclerosis is a form of arteriosclerosis, otherwise known as hardening of the arteries. The terms “atherosclerosis” and “arteriosclerosis” are sometimes used interchangeably, but they represent different conditions.

Read more about the difference between atherosclerosis and arteriosclerosis.

Untreated atherosclerosis may lead to:

abnormal heart rhythm (arrhythmias)

kidney disease and kidney failure

Read about the signs of strokes and heart attacks.

Atherosclerosis develops slowly and it’s often related to lifestyle habits, including diet patterns and reduced physical activity. Aging may also be a factor in atherosclerosis, but it doesn’t mean significant atherosclerosis always goes hand in hand with aging.

Chronic high cholesterol is the main contributing factor to atherosclerosis. Cholesterol is found naturally in the body and in certain foods.

If cholesterol levels in the blood are persistently elevated, it may lead to artery clogging. Over time, cholesterol in the arteries becomes a hard plaque that starts to restrict blood circulation and may damage blood vessels leading to blood clots.

Blood clots may move through blood flow and travel to other regions of the body. When they block blood flow to vital organs, like the brain, they can lead to serious complications.

Read more about the effects of cholesterol on the body.

Other contributing factors for atherosclerosis may include:

Family history: If atherosclerosis runs in your family, you may have a higher chance of narrowing of the arteries. You can inherit this condition, as well as other heart-related problems.

Lack of exercise: Regular exercise helps your cardiovascular system, including blood vessels, stay in optimal shape. It keeps your heart muscle strong and encourages oxygen and blood flow throughout your body. Low physical activity increases your chance of a host of medical conditions, including heart disease.

High blood pressure: Hypertension may damage your blood vessels by making them weak in some areas.

Smoking: Tobacco products may damage your blood vessels and heart.

Diabetes: People with diabetes have a much higher incidence of coronary artery disease.

A physical exam is the first step toward diagnosing atherosclerosis. A medical professional may check for:

a weakened pulse

signs of an aneurysm, or an abnormal bulging or widening of an artery due to weakness of the arterial wall

slow wound healing, which may indicate restricted blood flow

a bruit, or whooshing sound the blood makes as it travels through a blocked artery

Learn more about the difference between a stroke and an aneurysm.

A cardiologist may listen to your heart to check for atypical sounds and order more tests if they suspect atherosclerosis.

These tests may include:

blood tests to check cholesterol levels

a Doppler ultrasound, which uses sound waves to create an image of arteries and would show a blockage

an ankle-brachial index, which looks for a blockage in your arms or legs by comparing the blood pressure in each limb

a magnetic resonance angiography or a computed tomography angiography, which create pictures of the large arteries in your body

a cardiac angiogram, which is a type of chest X-ray that’s taken after your heart arteries are injected with radioactive dye. There are two types of cardiac angiography: Coronary CT angiography (CCTA) and left heart catheterization.

an electrocardiogram (ECG or EKG), which measures the electrical activity in your heart

a stress test, or exercise tolerance test, which monitors your heart rate and blood pressure while you exercise on a treadmill or stationary bicycle

You cannot reverse atherosclerosis, but management may help slow its progression.

Treatment for atherosclerosis typically involves lifestyle changes. Depending on its severity, risk factors, and symptoms, you may also need medications and surgery.

Medications can slow down the progression of atherosclerosis. These may include:

cholesterol-lowering drugs, including statins

angiotensin-converting enzyme (ACE) inhibitors, to lower blood pressure if needed

beta-blockers, to help your heart “rest”

antiplatelet drugs, such as aspirin, to prevent blood from clotting and clogging your arteries

Aspirin can be particularly effective for people with a history of atherosclerotic cardiovascular disease, including heart attack and stroke.

Discussing aspirin use for cardiovascular risk with a healthcare professional is highly advisable. Taking aspirin without the guidance of a doctor may lead to internal bleeding in some people.

If symptoms are severe or if muscle or skin tissue is in jeopardy, a healthcare professional may recommend surgery.

Possible surgeries for treating atherosclerosis include:

bypass surgery, which involves using a vessel from somewhere else in your body or a synthetic tube to divert blood around your blocked or narrowed artery

thrombolytic therapy, which involves dissolving a blood clot by injecting a drug into your affected artery

angioplasty and percutaneous coronary intervention, which involves using a catheter and a balloon to expand your artery, sometimes inserting a stent to keep the artery open

atherectomy, which involves removing plaque from your arteries by using a catheter with a sharp blade at one end

endarterectomy, which involves surgically removing fatty deposits from the carotid artery

Helpful lifestyle changes to slow down atherosclerosis may include:

eating a heart-healthy diet that’s low in saturated fats and cholesterol

avoiding fatty foods

adding fish to your diet twice per week instead of red meat

getting at least 75 minutes of vigorous exercise or 150 minutes of moderate exercise each week

doing strength training for at least 2 hours every week

quitting smoking if you use tobacco

managing your weight

treating conditions associated with atherosclerosis, such as hypertension, high cholesterol, sleep apnea, obesity, and diabetes

Atherosclerosis is the narrowing of your arteries by the accumulation of plaque. This plaque buildup is the result of chronic high cholesterol levels.

Once you develop atherosclerosis, the condition isn’t reversible. However, lifestyle changes, medications, and sometimes surgery may slow down its progression and prevent complications.

Common complications associated with atherosclerosis include strokes and heart attacks.