Atherosclerosis

Definition

Atherosclerosis is an inflammation process in blood vessels due to plaque buildup. Plaque is made of fats, cholesterol, and calcium. Over time, plaque and inflammation can narrow and harden the arteries.

Plaque buildup can slow and even stop blood flow. This can lead to problems such as:

• Coronary heart disease (CAD)—loss of blood flow to areas of the heart
• Stroke —loss of blood flow to areas of the brain
• Peripheral artery disease (PAD)—loss of blood flow to the legs or arms

Atherosclerosis

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Plaque can also weaken the walls of arteries. This can lead to a blood clot or aneurysm.

Causes

Atherosclerosis is caused by plaque. Plaque is created by high levels of cholesterol and fat in the blood. Scar tissue and calcium from prior injury can also add to plaque buildup.

Risk Factors

The risk of having atherosclerosis increases with age. Other things that may raise the risk are:

• Family history of the disease
• High cholesterol—especially:
  • High LDL ("bad") cholesterol
  • Low HDL ("good") cholesterol
• High blood pressure
• An unhealthful diet
• Cigarette smoking
• Diabetes type 1 and type 2
• Excess weight and obesity
• Lack of physical activity

Symptoms

Early atherosclerosis does not have symptoms. Symptoms may happen as the arteries become harder and narrow. Blockage from a clot can cause sudden symptoms.

Symptoms depend on which arteries are affected. For example:

• Coronary arteries of the heart—may cause symptoms of heart disease, such as chest pain
• Arteries to the brain—may cause symptoms of a stroke such as weakness, vision problems, speech problems, or headache
• Arteries in the legs—may cause pain in the legs or feet and problems walking

Diagnosis

Most people are diagnosed after they have symptoms. However, people can be screened and treated for risk factors.

The doctor will ask about symptoms and past health. A physical exam will be done. Tests depend on which arteries may be involved. Many tests detect problems with blood flow to tissues.

Tests may include:

• Angiography
• Cardiac catheterization
• Cardiac MRI
• Cardiac PET scan
• Ultrasound

Treatment

Lifestyle changes are an important part of treatment. They help reduce and reverse plaque buildup.

Other treatment depends on the area of the body affected. It may include:

Prevention

To help prevent and reverse atherosclerosis:

• Eat a healthful diet that is:
  • Low in saturated fat and cholesterol
  • Rich in whole grains, fruits, and vegetables
• Do regular physical activity.
• Reach and keep a healthy weight.
• Quit smoking or vaping.
• Manage long term conditions such as diabetes.
• Have regular doctor visits and screening tests.