Atherosclerosis

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Introduction

What is atherosclerosis?

Atherosclerosis is a condition in which circulating lipids, such as fats and cholesterol in the bloodstream, collect along the walls of arteries. This fatty material thickens and forms structures called plaques that narrow, and may eventually block blood flow through, the arteries. Large and medium-sized arteries are affected. Narrowing and blockage of arteries results in hypertension, chest pain, transient ischemic attack (TIA) or stroke, poor circulation to legs and feet, and other cardiovascular symptoms.

Atherosclerosis is a common cardiovascular disease in the United States. The disease is a leading cause of illness and death in the United States. Atherosclerosis is the most common cause for heart attack and stroke. Most commonly, people develop atherosclerosis as a result of diabetes, genetic risk factors, high blood pressure, a high-fat diet, obesity, high blood cholesterol levels, and smoking.

The signs and symptoms of atherosclerosis are usually not apparent until blood flow becomes restricted. The course of the disease varies among individuals. Some people with atherosclerosis have no symptoms at all, while others may have severe hypertension, aneurysm, blood clots, and coronary or peripheral artery disease. Fortunately, atherosclerosis can be treated successfully with medications, a healthy diet and lifestyle changes, and certain medical procedures. Even better, you can reduce your risk of atherosclerosis by following a heart-healthy diet, getting regular physical activity, and having regular checkups with your health care provider.

Left untreated, atherosclerosis may lead to severe blood clots, which can cause stroke, heart attack, or pulmonary embolism. Seek immediate medical care (call 911) for serious symptoms, such as sweating and severe difficulty breathing, which may be combined with pale or blue lips, fast heart rate, chest pain or pressure, loss of consciousness, severe headache, or sudden numbness or weakness. Seek prompt medical care if you are being treated for atherosclerosis but mild symptoms recur or are persistent, such as leg pain or chest pressure.

Symptoms

What are the symptoms of atherosclerosis?

Atherosclerosis narrows the arteries and reduces blood flow to body organs and tissues, resulting in a number of symptoms. The symptoms can vary in intensity among individuals. Mild atherosclerosis usually does not produce any symptoms. However, symptoms of moderate to severe atherosclerosis depend on which arteries are affected.

Common symptoms of atherosclerosis

The most common symptoms of atherosclerosis are related to disturbances in the arteries of the heart, brain and limbs.

Symptoms related to disturbances in heart arteries include:

  • Chest pain or pressure
  • Difficulty breathing or rapid breathing (tachypnea)

Symptoms related to disturbances in brain arteries include:

  • Drooping muscle in the face
  • Garbled or slurred speech or inability to speak
  • Sudden decreased vision or double vision
  • Sudden numbness in the arms or legs

Symptoms related to disturbances in arm and leg arteries include:

Serious symptoms that might indicate a life-threatening condition

In some cases, atherosclerosis can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

  • Blurred or double vision
  • Change in level of consciousness or alertness, such as passing out or unresponsiveness
  • Difficulty swallowing
  • Difficulty with memory, thinking, talking, comprehension, writing or reading
  • Numbness, weakness or paralysis of one side of the face
  • Rapid breathing (tachypnea) or shortness of breath
  • Rapid heart rate (tachycardia)
  • Severe back pain
  • Worst headache of your life

Causes

What causes atherosclerosis?

Atherosclerosis is caused by the accumulation in the bloodstream of fat, cholesterol, and other substances that build up on the walls of arteries and form hard structures called plaques. Plaque narrows and stiffens the arteries, making it difficult for blood to flow through the artery. In addition, pieces of plaque can break off and travel through the affected artery (embolize) and lodge in smaller blood vessels, blocking them and causing tissue damage, which may be life threatening. Atherosclerosis occurs most often in people who have a family history of heart disease or other risk factors for the development of atherosclerosis.

What are the risk factors for atherosclerosis?

A number of factors increase the risk of developing atherosclerosis. Not all people with risk factors will get atherosclerosis. Risk factors for atherosclerosis include:

  • Diabetes
  • High blood cholesterol levels
  • High blood pressure
  • High-fat diet
  • Advanced age
  • Obesity
  • Personal or family history of heart disease
  • Smoking

Reducing your risk of atherosclerosis

You may be able to lower your risk of atherosclerosis by:

  • Getting regular physical activity
  • Keeping your cholesterol at a healthy level
  • Maintaining normal blood pressure
  • Reducing the amount of cholesterol and fat in your diet
  • Quitting smoking or other tobacco use

Treatments

How is atherosclerosis treated?

Treatment of atherosclerosis begins with seeking medical care from your health care provider. To determine if you have atherosclerosis, your health care provider will ask you to undergo diagnostic testing.

Lifestyle changes and drug therapy are the mainstays of treatment for atherosclerosis. It is important to follow your treatment plan for atherosclerosis precisely and to take all of your medications as instructed to avoid complications.

Medical treatment of atherosclerosis

Antiplatelet medications that inhibit blood clot formation and that can be effective in the treatment of atherosclerosis include:

  • Aspirin

  • Clopidogrel (Plavix)

Surgical treatment of atherosclerosis

A number of surgeries may be performed to help prevent the complications of atherosclerosis including:

  • Abdominal aortic aneurysm repair (procedure to repair a weakened area in the wall of the aorta, the large artery that leads from the heart to the abdomen)

  • Angioplasty and stent placement (procedure to remove plaque and restore blood flow in clogged arteries)

  • Carotid artery surgery

  • Coronary artery bypass surgery (procedure to help restore blood flow to the heart by routing the flow through transplanted arteries)

  • Minimally invasive heart surgery

What you can do to improve your atherosclerosis

You may be able to improve your atherosclerosis by:

  • Adding fish to your diet at least twice a week

  • Eating several servings of fruits and vegetables every day

  • Eating well-balanced meals that are low in fat and cholesterol

  • Exercising regularly for 30 minutes a day if you are not overweight, and for 60 to 90 minutes a day if you are overweight

  • Getting your blood pressure checked regularly, especially if high blood pressure runs in your family

  • Having your cholesterol checked and treated if it is high

  • Limiting alcohol intake to one or two alcoholic drinks a day

  • Maintaining a healthy body weight, or losing weight if you are overweight or obese

  • Maintaining your blood pressure below 140/90 mm Hg

What are the potential complications of atherosclerosis?

Damage to heart, brain, liver, kidney, and other organs is a possible complication of atherosclerosis and can be serious and even life threatening in some cases. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you.

Complications of atherosclerosis include:

  • Coronary heart disease

  • Myocardial infarction (heart attack)

  • Organ damage (kidneys, brain, liver, and intestines)

  • Reduced circulation in the legs and feet

  • Stroke

  • Transient ischemic attack (temporary stroke-like symptoms that may be a warning sign of an impending stroke)

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Jan 4
  1. Atherosclerosis. PubMed Health, a service of the NLM from the NIH. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001224/
  2. Atherosclerosis. American Heart Association. http://www.heart.org/HEARTORG/Conditions/Cholesterol/WhyCholesterolMatters/Atherosclerosis_UCM_30556...
  3. Libby P, Ridker PM, Hansson GK. Progress and challenges in translating the biology of atherosclerosis. Nature 2011; 473:317.
  4. Bope ET, Kellerman RD (Eds.) Conn’s Current Therapy.Philadelphia: Saunders, 2012.
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