Atherosclerosis: Arterial Disease
What is atherosclerosis?
Atherosclerosis is a disease that occurs when plaque builds up on the inside walls of the arteries. Arteries are blood vessels that deliver blood and oxygen from the heart to the rest of the body.
Plaque is a sticky substance made of fat, cholesterol, calcium and other substances. As plaque builds up, the arteries become hard and narrow.
What’s the difference between atherosclerosis and arteriosclerosis?
Atherosclerosis is a type of arteriosclerosis, which is any hardening of the arteries. But the two terms are often used to mean the same thing.
How can hardening of the arteries affect my body?
Atherosclerosis may begin in childhood, and it gets worse over time.
Hardening of the arteries can cause several problems. Narrow or blocked arteries can’t deliver enough blood, oxygen and nutrients to the rest of the body. Blockages can eventually lead to tissue death or infection in the arms, legs or other parts of the body.
A piece of plaque can break free and then get stuck somewhere in the body, causing damage. Also, a blood clot can form in a narrow artery. It can eventually loosen and travel through the artery.
Atherosclerosis can lead to serious health problems and medical emergencies, including:
- Blood clots.
- Carotid artery disease.
- Chronic kidney disease.
- Coronary artery disease.
- Heart attack.
- Peripheral artery disease.
Who’s at risk for atherosclerosis?
Anyone can have atherosclerosis, but some people have a higher chance of developing it. Risk factors include:
- Diabetes mellitus.
- Family history of premature cardiovascular disease.
- High blood pressure (hypertension).
- High cholesterol.
- Lack of physical activity.
- Male gender.
- Older age (in men, age 45 and in women, age 55).
- Unhealthy diet high in saturated and trans fats, cholesterol, sodium (salt) and sugar.
Symptoms and Causes
What causes atherosclerosis?
Although scientists know the risk factors, they don’t completely understand why some people develop atherosclerosis and others don’t.
Many believe the condition begins because of damage to the endothelium, the artery’s inner lining. Smoking, high cholesterol, high blood pressure, high blood glucose and other factors may cause the damage. Plaque collects where the damage occurred. The material may then stimulate the body to produce more substances, which also collect. The arteries get progressively thicker, and blood flow decreases more and more.
What are the symptoms of atherosclerosis?
Atherosclerosis often doesn’t cause any symptoms until an artery is very narrow or entirely blocked. Many people don’t even know they have the condition until a medical emergency, such as a heart attack or stroke.
Diagnosis and Tests
How is atherosclerosis diagnosed?
To determine whether you have atherosclerosis, a healthcare provider will start with:
- Family medical history.
- Personal medical history.
- Physical exam, listening with a stethoscope for weak or absent pulse or an abnormal sound in your arteries called bruit.
- Blood tests, which can measure the amount of fat, cholesterol, sugar and protein in your blood.
Your healthcare provider may order tests to diagnose atherosclerosis and plan treatment, such as:
- Angiography, a test that uses special X-rays to locate and measure blockages. A contrast dye is injected into the arteries to help the blockages show up on the X-rays. The test is performed through a catheter inserted into an artery, usually in the groin or arm.
- Ankle/brachial index, which compares the blood pressure in your ankle to the pressure in your arm to measure blood flow in the limbs.
- Chest X-ray, which takes pictures inside your chest.
- CT scan, which takes pictures inside the body and can show hardening and narrowing of large arteries.
- Echocardiogram (echo), a painless test that takes pictures of the heart’s valves and chambers and measures pumping action.
- Electrocardiogram (EKG), a painless test that measures the heart’s electrical activity, rate and rhythm.
- Exercise stress test, which measures heart function while you are physically active.
What specialists might I need to see for arteriosclerosis?
If you have atherosclerosis, your healthcare provider may recommend you see a specialist, such as:
- Cardiologist, who specializes in the heart.
- Nephrologist, who specializes in the kidneys.
- Neurologist, who specializes in the nervous system (brain and spine).
- Vascular specialist, who specializes in the blood vessels.
Management and Treatment
How is atherosclerosis treated?
Treatment for atherosclerosis may involve lifestyle changes, medications and surgical procedures. The goals are to:
- Lower the risk of blood clots.
- Make healthier choices to prevent additional heart or vascular conditions.
- Prevent atherosclerosis-related diseases and complications.
- Relieve symptoms.
- Slow or stop plaque buildup.
- Widen or bypass clogged or blocked arteries.
Your healthcare team also may prescribe medications to:
- Control blood pressure.
- Lower cholesterol.
- Manage blood glucose levels.
- Prevent blood clots.
Some people with advanced atherosclerosis might require surgical procedures, such as:
- Coronary angioplasty, also called percutaneous coronary intervention, opens narrow or blocked coronary (heart) arteries. It’s performed through a catheter inserted into a groin artery (cardiac catheterization). The surgeon may place a stent (small tube) in the artery to prop it open.
- Coronary artery bypass surgery uses arteries or veins from other areas in your body to bypass (go around) a narrowed artery.
- Bypass surgery redirects blood from a clogged leg artery and improves blood flow to the leg.
- Carotid endarterectomy is surgery to remove plaque from the arteries in the neck to help prevent a stroke.
How can I prevent or lessen atherosclerosis?
You may not be able to prevent atherosclerosis completely. But you can reduce your risk and lessen the effects of the disease by:
- Eating a healthy diet low in saturated and trans fats, cholesterol, sodium (salt) and sugar.
- Exercising regularly.
- Maintaining a healthy weight.
- Managing any health conditions, especially diabetes, high blood pressure and high cholesterol.
- Quitting smoking.
- Having an annual checkup with your primary care provider.
Outlook / Prognosis
What is the outlook for people with atherosclerosis?
Medical advancements have helped improve the outlook for people with atherosclerosis. If the condition is caught early and treated, people with atherosclerosis can live healthy, active lives. But the disease can cause health emergencies and even death.
When should I seek immediate medical attention?
If you have any signs of heart attack or stroke, seek immediate medical attention. Symptoms may include:
- Chest pain.
- Difficulty breathing.
- Numbness in the arms, legs or elsewhere.
- Muscle weakness.
- Trouble walking.
- Slurred speech.
How can I best learn to cope with atherosclerosis?
Learning that you have atherosclerosis can cause fear and stress. It might help to:
- Attend support groups for people with the same condition.
- Share your feelings with your healthcare provider or a counselor.
- Talk to family and friends about the lifestyle changes you need to make so they can help you.
A note from Cleveland Clinic
Atherosclerosis is a disease that occurs when plaque builds up on the inside walls of the arteries. It often starts in childhood and gets worse over time. High blood pressure, high cholesterol, diabetes and other conditions can increase your risk. It’s important to get a checkup every year to catch and manage any related conditions. Healthy lifestyle choices, medications and surgical procedures can prevent complications of atherosclerosis.