Atherosclerosis is a condition where plaque (fatty deposits) builds up inside your arteries, causing them to become stiff and narrow. This can slow or block blood flow to your heart, brain, and other parts of your body.
Symptoms of atherosclerosis may vary from person to person, depending on which artery is affected and how narrow or blocked it is. Symptoms often aren’t noticeable until the plaque buildup is severe.
If symptoms do occur, they’re often related to a lack of oxygen in different areas. These symptoms may include:
- Chest pain
- Shortness of breath
- Dizziness
- Leg pain when walking
- Weakness
- Sudden numbness on one side of the body
- Confusion
- Difficulty speaking
Atherosclerosis may occur after damage to your arteries causes inflammation, which signals the buildup of things such as cholesterol and cell waste that can form plaques.
Some common causes of damage to the arteries include:
- High cholesterol levels
- High triglyceride (blood fat) levels
- High blood pressure
- High blood sugar related to diabetes
- Conditions, like rheumatoid arthritis or psoriasis, that cause inflammation
- Smoking exposure
- Your genetics
Risk Factors
Some other risk factors for atherosclerosis include:
- Family history: Your risk may be higher if close family members have had heart disease or high cholesterol.
- Limited physical activity: Sitting too much and not moving enough can lead to unhealthy cholesterol levels and increase your risk of atherosclerosis.
- Older age: The risk increases after age 45 for men and 55 for women.
- Overweight or obesity: Living with overweight or obesity raises your risk for heart disease and other health problems, such as type 2 diabetes, that may make atherosclerosis more likely.
- Race: Black Americans may have a higher risk of heart disease than white Americans.
- Diet: Foods that are high in saturated fat may raise your cholesterol, as can drinking excessively.
A healthcare provider may order tests to check for plaque buildup in your arteries if you have symptoms or risk factors of atherosclerosis. Diagnostic testing may include a physical exam and other testing, such as:
- Blood tests: These look at levels of cholesterol, triglycerides, blood sugar, and inflammation markers.
- Electrocardiogram (ECG or EKG): This painless test uses electrodes to check your heart’s rhythm and electrical activity.
- Imaging tests: Imaging such as angiography, cardiac magnetic resonance imaging, and ultrasound take pictures of your heart and blood vessels to check for plaque or problems with blood flow.
- Stress test: A stress test shows how your heart works when it’s working hard, such as during exercise.
The best way to manage atherosclerosis is to treat risk factors that can make it worse, such as high cholesterol, high blood pressure, and diabetes. Here are some key steps:
Exercise and Physical Activity
Each week, aim for 150 minutes of moderate exercise or 75 minutes of vigorous exercise. This can include walking, swimming, biking, or any activity that gets you moving.
Manage What You Eat
A heart-healthy diet may be low in saturated fats, trans fats, and salt. Aim for a diet that’s also high in:
- Fiber
- Fruits
- Vegetables
- Healthy fats, such as those from olive oil and avocados
- Fatty fish, like salmon
Medications
Depending on what is increasing your risk for atherosclerosis, your healthcare provider may discuss medications for lowering cholesterol, blood pressure, or blood sugar levels.
Procedures and Surgeries
Healthcare providers may recommend procedures to restore blood flow in serious cases of atherosclerosis. These procedures may include:
- Percutaneous coronary intervention (PCI): This procedure opens up narrow arteries of the heart and may involve the placement of a stent (small mesh tube).
- Coronary artery bypass grafting (CABG): This surgery uses a healthy blood vessel to create a new path around the blocked artery.
- Carotid endarterectomy: This procedure removes plaque from the carotid arteries, which carry blood from your heart to your brain.
- Carotid stenting: This surgery places a stent in a carotid artery to improve blood flow to your brain.
- Peripheral angioplasty: For blocked arteries in your legs, this procedure widens the arteries to improve blood flow.
For people with severe obesity, bariatric surgery (weight-loss surgery) may help lower the risk of atherosclerosis and reduce inflammation.
Atherosclerosis is largely preventable by managing your risk factors. Begin heart-healthy habits early, since atherosclerosis often starts in childhood and worsens over time.
Focus on eating a diet full of fruits and vegetables that’s low in saturated fats. Exercise regularly, maintain a healthy weight, and avoid smoking. If lifestyle changes aren’t enough, talk with your healthcare provider about medications that can help.
Getting regular screening and treatment to keep your blood pressure, blood sugar, and cholesterol in a healthy target range can also help prevent atherosclerosis.
Certain conditions that atherosclerosis may co-occur with or lead to include:
- Coronary heart disease: People with coronary heart disease have narrow or blocked arteries that feed the heart muscle.
- Peripheral artery disease: People with this condition may experience pain or muscle cramping with exercise. Usually, symptoms will go away once exercise stops. Some people have no symptoms.
- Vertebral artery disease: This condition happens when the inner layer of a blood vessel along the vertebrae (bones of the spine) becomes narrow or blocked. Symptoms can include cognitive difficulty and weakness or numbness on one side of the body or face.
- Carotid artery disease: If plaque builds up in the blood vessels from your heart to your brain, you may have this disease. It increases the risk of stroke.
- Mesenteric artery ischemia: This condition may occur when there is reduced blood flow to your small intestines. Symptoms can include severe pain after eating, weight loss, and diarrhea.
- Erectile dysfunction (ED): This can sometimes be an early warning sign of atherosclerosis in men. If you have ED, talk to your healthcare provider about your heart and artery health.
- Heart attack: A heart attack occurs when your heart muscle doesn’t get enough oxygen, which can happen with blocked arteries from atherosclerosis.
- Stroke: A stroke may happen if plaque buildup creates a blood clot that blocks oxygen to your brain.
Many people live long, active lives with atherosclerosis. Early treatment, heart-healthy habits, and medications can slow the disease. Stress management, staying active, and taking medications as directed can improve quality of life.