Atherosclerosis happens when arteries become narrow and hard due to a buildup of plaque around the artery wall. Atherosclerosis can lead to a heart attack, stroke, and other complications.
Other terms for the condition include arteriosclerosis and hardening of the arteries.
Plaque, which causes atherosclerosis, consists of cholesterol, calcium, fat, and other substances and can harden over time.
Smoking, high blood pressure, and other factors increase the risk of developing the condition.
The changes in a person’s arteries disrupt the flow of blood around the body and increase the risk of complications, such as a heart attack or stroke. These complications can be life threatening.
Atherosclerosis is the narrowing of arteries
Arteries carry blood from the heart to the rest of the body. A thin layer of cells forms a lining that keeps them smooth and allows blood to flow easily. This is called the endothelium.
Atherosclerosis occurs when the endothelium becomes damaged due to factors such as smoking, high blood pressure, or high blood glucose, fat, and cholesterol levels.
This damage allows a
Over time, plaque can build up and become hard.
If plaque continues to collect, it can block the artery and disrupt the flow of blood around the body.
Sometimes, pieces of plaque break open. If this happens, particles from blood cells, known as platelets, gather in the affected area. These can stick together, forming blood clots.
A clot can block the artery, leading to life threatening complications, such as stroke and heart attack.
Atherosclerosis can affect any artery, but it mainly occurs in the larger, high-pressure arteries.
Atherosclerosis usually affects older people, but it can start to develop during adolescence. Inside the artery, streaks of white blood cells will appear on the artery wall.
Often, there are no symptoms until a bit of plaque ruptures or the blood flow becomes restricted. This may take many years to occur.
The symptoms of atherosclerosis depend on which arteries are affected.
Carotid arteries
Carotid arteries provide blood to the brain. A restricted blood supply can lead to a stroke.
Symptoms of stroke can appear suddenly and
- weakness
- difficulty breathing
- headache
- facial numbness
- paralysis
If a person has signs of a stroke, they need immediate medical attention.
The acronym
- F for face: One side of the face may droop. Ask the person to smile, and check if one side does not move or looks uneven.
- A for arms: One arm may feel weak or numb. Ask the person to raise both arms to check if one drifts downward.
- S for speech: The person’s speech may be slurred or hard to understand. Ask the person to repeat a sentence clearly to check.
- T for time: It is time to call emergency services immediately if any of these signs are present.
Coronary arteries
Coronary arteries provide blood to the heart. When the blood supply to the heart falls, it can cause angina and heart attack.
A person may experience:
- chest pain
- vomiting
- extreme anxiety
- coughing
- faintness
Symptoms can change based on age or even sex. Older patients, and especially older females, tend to have milder symptoms. These can include increased fatigue, exercise intolerance, or acid reflux-like symptoms.
Renal arteries
Renal arteries supply blood to the kidneys. If the blood supply becomes limited, chronic kidney disease may develop.
Someone with renal artery blockage significant enough to cause chronic kidney disease may experience:
- loss of appetite
- swelling of the hands and feet
- difficulty concentrating
Renal artery stenosis is a common cause of secondary hypertension, which can make high blood pressure very difficult to treat. If a person is taking many blood pressure medications but having a hard time controlling the pressure, it may be worth checking the renal arteries.
Peripheral arteries
These arteries supply blood to the arms, legs, and pelvis.
If blood cannot circulate effectively, a person may experience numbness and pain in their limbs, called claudication. It typically worsens with exertion, especially when walking uphill or up stairs.
In severe cases, tissue death and gangrene can occur.
Peripheral artery disease also increases the risk of a stroke or heart attack.
Atherosclerosis can be life threatening, but treatment is available. Receiving treatment early can reduce the risk of severe complications.
Treatment aims to slow or stop the development of plaque, prevent blood clots from forming, and treat symptoms.
Options include:
- lifestyle changes
- medications
- surgery
Lifestyle changes
The following lifestyle choices might reduce the risk:
- avoiding or quitting smoking
- consuming alcohol in moderation
- getting regular exercise
- following a balanced diet
- maintaining a healthy weight
Adopting these practices from early adulthood may help prevent problems later in life.
Medication
A doctor will prescribe medications to suit an individual’s needs, depending on their overall health and other conditions.
Drugs known as statins can help manage a person’s cholesterol levels.
Other medications can lower blood pressure, reduce blood sugar, and prevent clots and inflammation.
People should follow their doctor’s instructions and not discontinue a drug without seeking medical advice. They should also follow a healthful lifestyle, as well as using medication.
Surgery
Sometimes a person will need surgery to ensure that blood in their arteries continues to flow effectively.
Options include:
- using a stent to widen the blood vessel
- bypass surgery to carry blood around the affected area
- surgery to remove plaque buildup, for example, in the neck
These options may help a person with severe atherosclerosis.
The complications of atherosclerosis include:
- heart disease, heart attack, or heart failure
- peripheral artery disease
- kidney failure
- aneurysm
- stroke
- irregular heart rhythms and palpitations
- embolism when a piece of the clot breaks off and travels to another part of the bloodstream
People with a
- diabetes or insulin resistance
- a family history of cardiovascular disease
- a history of tobacco smoking
- high levels of low-density lipoprotein (LDL), or “bad” cholesterol
- low physical activity levels
- older age
- a diet high in saturated fat, trans fat, cholesterol, salt, and sugar
- high blood pressure
- obesity
- high levels of triglycerides in the blood
- stress
- high alcohol intake
- sleep apnea
Recent evidence indicates that inflammation may play a role. Older research from 2018 suggests that air pollution could increase the risk by triggering inflammation.
Atherosclerosis is a serious condition that can have life threatening consequences. It can affect people of any age, but symptoms are most likely to appear as people get older.
One way to reduce the risk of atherosclerosis is to follow a healthy lifestyle from an early age. For those with atherosclerosis, a doctor can advise on treatment and lifestyle choices to reduce the risk of complications.