Atherosclerosis is a disease where plaque builds up in the arteries, limiting blood flow. Over time, plaque hardens and narrows the arteries. This can lead to serious problems like heart attack or stroke if it reduces blood flow too much. The plaque is made up of substances like fat, cholesterol, and calcium. Risk factors include smoking, high cholesterol, high blood pressure, and diabetes. Atherosclerosis can affect arteries throughout the body and lead to diseases like coronary heart disease, stroke, or peripheral arterial disease depending on where the blockages occur. Lifestyle changes and medication can help prevent atherosclerosis from worsening.

1. What Is Atherosclerosis?
Atherosclerosis (ath-er-o-skler-O-sis) is a disease in which plaque (plak) builds up inside your arteries.
Arteries are blood vessels that carry oxygen-rich blood to your heart and other parts of your body.
Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. Over time,
plaque hardens and narrows your arteries. This limits the flow of oxygen-rich blood to your organs and
other parts of your body.
Atherosclerosis can lead to serious problems, including heart attack, stroke, or even death.
Atherosclerosis
Figure A shows a normal artery with normal blood flow. Figure B shows an artery with plaque
buildup.

2. What Causes Atherosclerosis?
Atherosclerosis starts when high blood pressure, smoking, or high cholesteroldamage the endothelium. At
that point, cholesterol plaque formation begins.
Cholesterol invasion. Bad cholesterol, or LDL, crosses damaged endothelium. The cholesterol enters the
wall of the artery.
Plaque formation. Your white blood cells stream in to digest the LDL cholesterol. Over years, the
accumulating mess of cholesterol and cells becomes a plaque in the wall of the artery.
Atherosclerosis tends to happen throughout the body. "So if you have plaque in your heart, you're at a
higher risk for stroke, and vice versa," says Stein.
Atherosclerosis usually causes no symptoms until middle or older age. Once narrowings become severe,
they choke off blood flow and can cause pain. Blockages can also suddenly rupture, causing blood to clot
inside an artery at the site of the rupture.
Atherosclerosis-Related Diseases
Atherosclerosis can affect any artery in the body, including arteries in the heart, brain, arms, legs,
pelvis, and kidneys. As a result, different diseases may develop based on which arteries are affected.
Coronary Heart Disease
Coronary heart disease (CHD), also called coronary artery disease, is the #1 killer of both men and
women in the United States. CHD occurs if plaque builds up in the coronary arteries. These arteries
supply oxygen-rich blood to your heart.
Plaque narrows the coronary arteries and reduces blood flow to your heart muscle. Plaque buildup also
makes it more likely that blood clots will form in your arteries. Blood clots can partially or completely
block blood flow.
If blood flow to your heart muscle is reduced or blocked, you may have angina(chest pain or
discomfort) or a heart attack.
Plaque also can form in the heart's smallest arteries. This disease is calledcoronary microvascular
disease (MVD). In coronary MVD, plaque doesn't cause blockages in the arteries as it does in CHD.
Carotid Artery Disease
Carotid (ka-ROT-id) artery disease occurs if plaque builds up in the arteries on each side of your neck
(the carotid arteries). These arteries supply oxygen-rich blood to your brain. If blood flow to your
brain is reduced or blocked, you may have a stroke.

3. Peripheral Arterial Disease
Peripheral arterial disease (P.A.D.) occurs if plaque builds up in the major arteries that supply oxygen-
rich blood to your legs, arms, and pelvis.
If blood flow to these parts of your body is reduced or blocked, you may have numbness, pain, and,
sometimes, dangerous infections.
Chronic Kidney Disease
Chronic kidney disease can occur if plaque builds up in the renal arteries. These arteries supply
oxygen-rich blood to your kidneys.
Over time, chronic kidney disease causes a slow loss of kidney function. The main function of the
kidneys is to remove waste and extra water from the body.
Atherosclerosis Prevention
Atherosclerosis is progressive, but it's also preventable. For example, nine risk factors are to blame for up
to 90% of all heart attacks:
Smoking
High cholesterol
High blood pressure
Diabetes
Abdominal obesity ("spare tire")
Stress
Not eating fruits and vegetables
Excess alcohol intake (more than one drink for women, one or two drinks for men, per day)
Not exercising regularly
Atherosclerosis Treatment
Once a blockage is there, it's generally there to stay. With medication and lifestyle changes, though,
plaques may slow or stop growing. They may even shrink slightly with aggressive treatment.
Lifestyle changes: Reducing the lifestyle risk factors that lead to atherosclerosis will slow or stop the
process. That means a healthy diet, exercise, and no smoking. These lifestyle changes won't remove
blockages, but they’re proven to lower the risk of heart attacks and strokes.
Medication:Taking drugs for high cholesterol and high blood pressure will slow and perhaps even halt
the progression of atherosclerosis, as well as lower your risk of heart attacks and stroke.
Using invasive techniques, doctors can also open up blockages from atherosclerosis, or go around them:
Angiography and stenting: Cardiac catheterization with angiography of the coronary arteries is the
most common angiography procedure performed. Using a thin tube inserted into an artery in the leg or

4. arm, doctors can access diseased arteries. Blockages are visible on a live X-ray screen. Angioplasty
(catheters with balloon tips) and stenting can often open up a blocked artery.
Bypass surgery: Surgeons "harvest" a healthy blood vessel (often from the leg or chest). They use the
healthy vessel to bypass a segment blocked by atherosclerosis.
These procedures involve a risk of complications. They are usually saved for people with significant
symptoms or limitations caused by atherosclerosis.