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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:
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:

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:

Treatment

Lifestyle changes are an important part of treatment (see Prevention below). They help reduce and reverse plaque buildup.
Other treatment depends on the area of the body affected. It may include:

Medication

Medicines can help:
  • Prevent blood clots
  • Control high blood pressure
  • Lower cholesterol
  • Improve blood flow

Catheter-based Procedures

These procedures involve passing a thin tube to the diseased artery and repairing it. They include:
  • Balloon angioplasty —a balloon widens the artery to increase blood flow
  • Stenting (often done after angioplasty)—a wire mesh tube is placed in the artery to keep it open
  • Atherectomy (not used as often)—cuts away and removes plaque

Surgery

Surgery options include:
  • Endarterectomy—removes plaque buildup from the artery (often in the neck)
  • Arterioplasty—repairs an aneurysm (often with manmade tissue)
  • Bypass—creates a new path for blood flow around a blocked area

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.
  • Manage long term conditions such as diabetes.
  • Have regular doctor visits and screening tests.

RESOURCES

American Heart Association
http://www.heart.org
National Heart, Lung, and Blood Institute
https://www.nhlbi.nih.gov

CANADIAN RESOURCES

Canadian Cardiovascular Society
http://www.ccs.ca
Heart and Stroke Foundation of Canada
http://www.heartandstroke.ca

References

Atherosclerosis. American Heart Association website. Available at: https://www.heart.org/en/health-topics/cholesterol/about-cholesterol/atherosclerosis#.Wpg9d2rwZQI. Accessed September 15, 2021.
Atherosclerosis. National Heart, Lung, and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health-topics/atherosclerosis. Accessed September 15, 2021.
Coronary artery disease. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/coronary-artery-disease-cad. Accessed September 15, 2021.
Geovanini GR, Libby P. Atherosclerosis and inflammation: overview and updates. Clin Sci (Lond). 2018;132(12):1243-1252.
Heart and stroke statistics. American Heart Association website. Available at: https://www.heart.org/en/about-us/heart-and-stroke-association-statistics. Accessed September 15, 2021.

Revision Information

  • Reviewer: EBSCO Medical Review Board Nicole Meregian, PA
  • Review Date: 07/2021
  • Update Date: 09/15/2021