Everything To Know About Atherosclerosis Prevention

Introduction

Atherosclerosis occurs when there is plaque buildup in the arteries, which makes them narrow and restrict the usual blood flow. Arteries are the blood vessels that transport oxygen rich blood from your heart to other parts of the body. Atherosclerosis is more common in old age, though the signs can start as young as adolescence. Can atherosclerosis be prevented? To some extent, atherosclerosis prevention is possible by making the right lifestyle changes, such as exercising daily and opting for healthy food habits. Moreover, one can reduce the risk of atherosclerosis by getting regular heart check-ups and following the medication or treatment plan properly. Read on to find more information about atherosclerosis, its causes, symptoms, treatment and expert advice on atherosclerosis prevention.

What is Atherosclerosis?

Over a period of time, various factors like an unhealthy diet, chronic inflammation, and collagen-vascular diseases can cause calcium, cholesterol and fats to build up on the walls of arteries and form plaque. This plaque buildup makes it hard for your blood to flow through the arteries. It might occur in any of the arteries, which includes arteries of your kidneys, brain, legs and heart.

Atherosclerosis restricts blood flow and can cause stroke, heart attack and blood clots. Though atherosclerosis is a common condition associated with ageing^[1], it might even begin in childhood and keep getting worse with each passing year. Suitable medications and lifestyle changes can help in preventing atherosclerosis and its complications. 

Difference Between Arteriosclerosis and Atherosclerosis

Arteriosclerosis is a condition where the arteries become hard and stiff mainly due to ageing. Atherosclerosis is a type of arteriosclerosis. Atherosclerosis refers to the buildup of plaque deposits in the walls of blood vessels, resulting in restricted blood flow.

How Common Is Coronary Atherosclerosis?

The cases of coronary atherosclerosis (hardening and narrowing of the blood vessels that supply the heart) have been on the rise in India in the past couple of years. However, it is hard to get an actual figure on the total number of cases because of a lack of case reporting and large-scale studies on this matter. The existing reports have shown that the disease is more common in men than women. The rate of prevalence of coronary atherosclerosis is 78% in males and 66.6% in females^[2].  

Stages of Atherosclerosis

Atherosclerotic plaque buildup can be divided into four major stages :

• Endothelial dysfunction: This essentially means that there are no blockages in the major artery, but instead, the larger blood vessels on the surface of the heart begin to constrict rather than dilate.
• Formation of fatty streaks or fatty deposits in the inner coat of the artery: Fatty streaks are generally the first signs of atherosclerosis. These fatty streaks form in the cells, which can form plaque and lead to atherosclerosis.
• Inflammation reaction: The fatty deposits in the inner wall of the artery start to react with the body and attract inflammatory cells. This causes the plaque build-up to increase.
• Formation of smooth muscle cell caps: Smooth muscle cells are those that line the inner parts of hollow organs of the body like the intestines, lungs, arteries, bladder, etc. Smooth muscle cells now begin to form a cap of somewhat fibrous texture on the plaque surface. A thick cap stabilises the plaque, while a thin cap increases rupture risk.

Furthermore, plaque formation can be divided into three stages, which are:

• The fatty streak: The initial stage and one of the earliest signs of atherosclerosis.
• Plaque progression: The moderate stage where the plaque builds up is now significant and starting to narrow the arteries.
• Plaque disruption: The severe stage where the arteries are almost completely blocked, increasing the risk of various atherosclerosis complications such as a heart attack or a stroke.

It is important to take the right steps for managing atherosclerosis before it reaches the third stage.

To Summarize

• Atherosclerosis causes the hardening of the arteries and blood clots due to plaque buildup in the arteries. 
• It is a particular kind of arteriosclerosis that mainly occurs due to ageing. 
• As per the available data, atherosclerosis has been on the rise in India, though there is a serious lack of studies to accurately know the exact number of cases per year.
• The three main stages of atherosclerotic plaque are the fatty stage, plaque progression and plaque disruption.

Common Symptoms of Atherosclerosis

One of the main challenges of atherosclerosis prevention is that the symptoms in most cases do not show until the artery is almost closed or there is a medical emergency like a stroke or heart attack. Signs also depend on the location of the blocked or narrowed artery.

Atherosclerosis symptoms usually do not appear in the early or mild stages. It’s only when the artery starts narrowing to a point where it obstructs blood flow to the heart that symptoms start showing. The symptoms of atherosclerosis usually depend on which arteries in the body are affected. Therefore: 

• If the blockage is in the arteries of the heart, some of the common symptoms you may experience are chest pain, tightness or heaviness – also known as angina.
• If the arteries that lead to the brain are blocked, then symptoms like slurred speech, blurred vision, unexplained change in behaviour, memory issues, drooping facial muscles and numbness/weakness in the limbs may follow. 
• If a blockage is present in the arteries of the limbs, you may experience pain in the leg while walking. This may also be indicative of peripheral artery disease.
• If atherosclerosis is present in the arteries associated with the kidneys, chances are that you may develop high blood pressure or kidney failure if left undiagnosed.

Serious Complications of Untreated Atherosclerosis

It is important to take the right steps to prevent atherosclerosis on time because failing to do so might lead to several complications. Again, just like the symptoms, the complications that can arise from atherosclerosis depend on the affected arteries in the body.

• Atherosclerosis of the heart arteries can lead to heart attacks if ignored. 
• Similarly, atherosclerosis of the brain arteries can lead to strokes. 
• Atherosclerosis of the limb arteries can lead to peripheral artery disease that can cause further damage to the arms and legs.
• Lastly, atherosclerosis of the arteries leading to the kidney can cause high blood pressure emergencies and kidney failure if left untreated.

When Should You See a Doctor?

Atherosclerosis, if ignored, tends to get worse with each day. So, talk to your doctor if you suspect that you have the disorder. Also, remember to pay close attention to the early signs of obstructed blood flow, such as numbness, leg pain or chest pain.  

Early treatment and diagnosis can prevent the disease from getting worse and causing a stroke, heart attack, or any other such medical emergency.

To Summarize

• The common signs of atherosclerosis are chest pain, numbness, high blood pressure, weakness, kidney failure, shortness of breath and temporary vision loss. The symptoms depend on the artery that has been affected.
• Failing to detect and prevent the condition in time might lead to medical emergencies like strokes and heart attacks.
• Pay close attention to the early signs of obstructed blood flow, such as numbness, leg pain or chest pain. Talk to your doctor if you experience any of the symptoms.

Causes & Risk Factors of Atherosclerosis

Arteries are the blood vessels that take blood from the heart throughout the body. These are lined by a thin cell layer known as the endothelium. It keeps your blood flowing by keeping the insides of the arteries smooth and in shape. Arteriosclerosis causes stiffness and thickening of the walls of arteries, leading to obstruction in blood flow.

Plaque forms a bump on the inner side of the arterial wall. When the condition gets worse, this bump keeps getting bigger. It creates a blockage when it is big enough. Atherosclerosis can affect different blood vessels in your body. Thus, your heart is not the only organ at risk. You are also at high risk for stroke and several other health problems.

What are the Causes of Atherosclerosis?

Several factors can be attributed as causes of atherosclerosis, siuch as:

• High cholesterol and high triglycerides: Atherosclerosis is associated with high cholesterol and triglycerides. LDL cholesterol damages endothelium and enters the arterial walls. The white blood cells come in to digest the cholesterol. Gradually, the cholesterol builds up as plaque in the arteries. 
• Smoking and tobacco use: Smoking^[3]is one of the main causes of atherosclerosis because it damages the endothelium, leading to plaque buildup.  
• Insulin resistance, obesity or diabetes: All these lead to inflammation in the body, which slows down blood flow and increases the risk of atherosclerosis of the aorta. Inflammation from other diseases such as arthritis, collagen-vascular diseases, lupus, psoriasis or inflammatory bowel disease.

What are the Risk Factors for Atherosclerosis?

The signs of atherosclerosis can begin when you are young. In fact, even teenagers might have the signs. People who are generally healthy and are above forty years of age have at least a 50% chance of getting the disorder in their lifetime. Atherosclerosis risk factors get higher as you age. Most adults over the age of sixty have some degree of atherosclerosis but most of them do not have noticeable symptoms.

Given below are the atherosclerosis risk factors that you should be aware of:

• High cholesterol 
• High blood pressure 
• High levels of C-reactive protein or CRP (a marker of inflammation) over a long period of time
• Diabetes or prediabetic 
• Obesity 
• Sleep apnea 
• Smoking and tobacco use 
• A family history of early heart disease
• Lack of exercise
• An unhealthy diet 
• Medical history of chronic inflammatory diseases

Better lifestyle choices and improved treatment facilities have reduced the rates of death and made atherosclerosis prevention possible in the past decade. However, it is still important to be cautious about the given risk factor.

To Summarize

• Preventing atherosclerosis begins with managing the condition/underlying cause that may be responsible for atherosclerosis.
• The effects of atherosclerosis can be seen in people who are generally healthy and above forty years of age. They have at least a 50% chance of getting the disorder in their lifetime.
• Atherosclerosis is associated with symptoms that can show even during adolescence.
• High cholesterol, obesity, smoking, lack of exercise, diabetes and high blood pressure are the general causes of atherosclerosis.

How is Atherosclerosis Diagnosed?

The first step to preventing this condition is to understand the risk factors and minimise them. As such, there are several ways to diagnose atherosclerosis in India after an individual shows signs of atherosclerosis^[4].

1. Medical history

• Presence of any risk factors (high blood pressure, high cholesterol, obesity and smoking)
• Symptoms of atherosclerosis (as mentioned above)

2. Physical exam 

If your doctor notices symptoms of atherosclerosis, they will perform physical exams to check for:

• A weakened pulse 
• Slow wound healing (indicating an obstructed blood flow) 
• Aneurysm (Abnormal widening or bulging of arteries because of weak arterial walls) 
• A whooshing or bruit sound is made by the blood as it passes through restricted arteries.

3. Blood tests to check cholesterol and triglycerides

Doctors order blood tests to check cholesterol and blood sugar levels in the case of cerebral atherosclerosis. A C-reactive protein (CRP) test might also be carried out to look for the protein that is linked to the inflammation of your arteries. 

4. Doppler ultrasound test 

Doppler ultrasound is a special ultrasound device that measures blood pressure at different points along the leg or arm. The measurements help doctors understand the speed of arterial blood flow and the degree of blockages.

5. CT scan

A Computerized Tomography (CT) scan is a common test that uses imaging for creating detailed pictures of the heart or brain and detecting the development of atherosclerosis. It can also show calcium deposits present in the artery walls. 

6. Ankle/Brachial index 

It is a test that tells whether you have blockages in the arteries in your feet and legs. During this test, doctors compare the blood pressure in the arm with that in the ankle. Abnormal differences are seen as signs of peripheral vascular diseases (blood circulation disorders that mostly cause leg pain), which are typically indicative of the development of atherosclerosis.  

7. Angiogram of the heart 

The doctor inserts a flexible, thin tube called a catheter in the blood vessel and to the heart. A type of dye goes through the catheter, which fills the arteries. When the arteries appear on X-ray, the blocked areas are revealed. 

8. ECG or EKG reports 

The painless and simple test records all the electrical signals in the heart. It can help in identifying complications like heart attack due to the different types of atherosclerosis. 

9. Stress test 

You will have to ride stationary exercise bikes or treadmills while staying connected to an ECG. Exercising makes the heart pump faster and harder than usual. Thus, it can indirectly help to pick up heart problems like atherosclerosis and arteriosclerosis earlier by increasing the oxygen demand of the heart, which might be otherwise missed.

How to Prepare for Atherosclerosis Diagnosis?

In order to come prepared for your diagnosis, here’s what you need to do:

• Bring all your previous diagnostic images and pathology reports to the scheduled appointment.
• Wear loose-fitting, warm and comfortable clothes.
• Avoid garments that have heavy buckles and metal components.
• Leave all your valuables at home.
• Get in touch with your doctor’s clinic or hospital to know about any additional preparation instructions.
• Avoid caffeine or any other such stimulant at least 24 hours before the diagnosis.

Understanding Your Atherosclerosis Test Results

Look for the following markers in your report to understand your chances of having atherosclerosis:

• Deranged lipid profile (High levels of LDL and triglycerides and low levels of HDL)
• An abnormality detected in CT scans or ultrasound reports
• Persistently high levels of CRP

What to Do After Getting Your Results?

It usually takes about a day for you to receive the results of the reports. After you receive the results, get in touch with your doctor immediately to understand the diagnosis and the right course of treatment for your condition. The medications and treatment will depend upon the type of atherosclerosis.

To Summarize

• Atherosclerosis is diagnosed through physical tests, blood tests, CT scans, angiograms, etc. 
• Get in touch with your doctor’s office to know about the instructions to get prepared for the diagnosis. 
• After you receive your medical reports, schedule an appointment with your doctor without further delay.

What Are the Complications of Atherosclerosis?

As atherosclerosis advances, it can lead to serious complications affecting various organs and systems in the body.

What Happens When Atherosclerotic Plaques Rupture?

Plaque buildup in arteries can lead to blockages in the arteries, which can cause a medical emergency like a heart attack. Also, plaque buildup in arteries that develop from atherosclerosis might behave in various ways. 

They might stay in the artery wall, where the plaque builds up but is not big enough to block blood flow, thus no symptoms might ever show up. In other cases, plaques can grow in slow and controlled ways in the path of your blood flow, causing major blockages with time. The usual symptom is pain in the legs or chest while exerting yourself.

According to atherosclerosis pathophysiology, the worst situation is when the plaque ruptures suddenly. This can lead to the formation of blood clots, increasing the risk of stroke (if in the brain) or heart attack (if in the heart).

The plaques can lead to several major types of cardiovascular complications:

1. Stroke

Plaque rupture in the arteries of the brain leads to strokes with chances of permanent brain damage and disability. Even temporary blocks in the artery might lead to something known as transient ischemic attacks (occurs when blood flow to part of the brain is blocked by a blood clot that are warning signals of a stroke, which do not cause brain injury).

2. Coronary Artery Disease 

Stable plaques in the arteries of the heart lead to complications of atherosclerosis, like chest pain. A heart attack, also known as a myocardial infarction, occurs when heart muscle cells die due to a sudden blockage in the blood supply to the heart, usually caused by a ruptured plaque.

3. Carotid Artery Disease 

Plaques block the blood vessels that ensure blood flow to your brain and that leads to a stroke.

4. Peripheral Artery Disease 

Narrowing arteries in the legs can cause poor circulation, which makes it hard for you to walk. It even makes it hard for wounds to heal. As the disease progresses, one might need an amputation of the limb. 

5. Aneurysms 

Plaque can cause a bulge in the walls of the arteries (aneurysm), which blocks the blood flow and increases the chances of rupture of the artery.

6. Chronic Kidney Disease 

Atherosclerotic plaque can obstruct the tiny blood vessels of the kidneys, thereby causing chronic kidney disease.

To Summarize

• Plaque buildup can lead to blockages in the arteries that cause a medical emergency like a heart attack or stroke. 
• The consequences of atherosclerosis include blood clots inside the arteries, a stroke in the brain or a cardiac arrest in the heart. 
• Some of the major complications arising out of plaque buildup are carotid artery disease, peripheral artery disease, coronary artery disease and chronic kidney disease.

Atherosclerosis Treatment

Atherosclerosis treatment involves surgical and invasive procedures and medication, which have been discussed below.

1. Surgical and Invasive Procedures

Surgery is one of the surest ways of atherosclerosis treatment if skin tissues or muscles are endangered and the symptoms are severe. There are four possible surgeries to treat the condition:

• Stenting: Percutaneous coronary intervention (a minimal-invasive method that helps with opening up clogged arteries) with an angioplasty involves the use of a balloon and a catheter to expand the artery and insert a stent inside to keep it open.
• Bypass Surgery: It involves utilising a vessel from anywhere else in the body or a kind of synthetic tube for diverting the passage of blood flow away from narrowed or blocked arteries. 
• Endarterectomy: The doctor reaches the arteries in the neck for plaque removal and restores blood flow. 
• Fibrinolytic Therapy: It involves injecting a drug into the affected artery to dissolve the blood clot resulting from plaque in arteries.

2. Medications

Several drugs are available nowadays for atherosclerosis prevention or to reverse the consequences of atherosclerosis.

• Blood Thinners: Doctors might prescribe blood thinners, like aspirin, to bring down the risk factors. It prevents platelets from clumping in narrow arteries, forming blood clots and causing more blockage. 
• Blood Pressure Medicines: Drugs that lower blood pressure are not meant to reverse atherosclerosis but to treat or prevent complications related to the disorder. Certain medications for managing high blood pressure might also help in reducing your risk of a heart attack. 
• Lipid Lowering Medicines: Aggressive lowering of the LDL (low-density lipoprotein) cholesterol, i.e., the bad cholesterol, and triglycerides can stop, slow or reverse the buildup of plaque in arteries. 
• Other Medicines: Doctors might suggest other medicines for controlling health conditions that increase the risk of the disease, like diabetes. Moreover, particular medications for treating the symptoms of atherosclerosis, like leg pain at the time of exercise, might be prescribed.

To Summarize

• The buildup of plaque in arteries can be reversed through medication or prevented through surgeries. 
• It is important to take your daily medications related to blood pressure, high cholesterol and high blood sugar to prevent the condition from progressing.
• Stenting bypass surgery, endarterectomy and fibrinolytic therapy are the ways to prevent arterial blockages.

How to Prevent Atherosclerosis?

Atherosclerosis prevention^[5] involves a series of lifestyle changes that can lower the risk of the disease from occurring or relapsing.

1. Quitting Smoking

Smoking damages the arteries by causing a buildup of plaque in the arteries. Quitting cigarettes is one of the best steps you can take to keep the arteries healthy and prevent heart complications.

2. Eating Healthy 

A healthy diet is full of whole grains, vegetables, low fat dairy and fruits, which are low in refined carbohydrates, sodium, saturated fat and sugars. Make sure to have a small portion of nuts and seeds for healthy fats regularly. A balanced diet, when consumed in controlled portions, is helpful.

3. Exercising Regularly

Regular exercise helps to improve blood flow, lower blood pressure and reduce the risk of conditions that raise the risk of heart disease and atherosclerosis.  

Exercise at least three days a week for a minimum of thirty minutes, if not regularly, to help reverse atherosclerosis. If you can’t do thirty minutes at one go, break up a session into ten-minute intervals. Take a walk around the block after lunch or take the stairs rather than the elevator.

4. Maintaining a Healthy Weight

Atherosclerosis is a condition in which it is important to maintain a healthy weight and lose extra pounds. When you are overweight, shedding even a few kilos can significantly reduce the risk of high cholesterol and high blood pressure – the biggest risk factors for atherosclerosis. For atherosclerosis prevention, ask your doctor about your target weight.

5. Monitoring and Managing Blood Pressure

Avoid skipping your blood pressure medication and regularly monitor your blood pressure. Also, reduce stress in your daily life through different relaxation techniques because it can be a major contributing factor for high blood pressure levels.

6. Keeping Your Cholesterol and Blood Sugar in Check

If you have high blood sugar or deranged cholesterol levels or any other chronic disease, make sure to discuss that with your doctor. Your doctor will help you in managing the condition and promote general well-being.

To Summarize

• In order to prevent the recurrence of the disease, you will have to make certain lifestyle changes – starting with giving up cigarettes. 
• Make sure to eat healthily and include fruits, veggies and nuts in your daily diet.
• Get regular exercise for at least thirty minutes to keep your heart healthy. 
• Monitor blood pressure, cholesterol and sugar regularly.

You will see significant improvement in your condition with the correct treatment and lifestyle changes. However, atherosclerosis prevention is something that needs serious commitment from your end in terms of changing food habits, regular checkups and daily exercises. When going through the treatment, it is important to stick to it and go through it religiously so that you get the best results. There may be times when it gets difficult, but in the long run, you will thank yourself for all the effort and time that you have spent on yourself to lead a healthier life.

Also Read: Everything to Know About Irregular Heartbeat (Arrhythmia)

Frequently Asked Questions (FAQs)

References

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2. Singh H, Oberoi SS, Gorea RK, Bal MS. Athersclerosis in coronaries in Malwa region of Punjab. Journal of Indian Academy of Forensic Medicine. 2005;27(4):236–39. [Accessed 2025 Mar 6]. https://www.researchgate.net/publication/236624239_Atherosclerosis_in_Coronaries_in_Malwa_Region_of_Punjab
3. Kong C, Nimmo L, Elatrozy T, Anyaoku V, Hughes C, Robinson S, Richmond W, Elkeles RS. Smoking is associated with increased hepatic lipase activity, insulin resistance, dyslipidaemia and early atherosclerosis in Type 2 diabetes. Atherosclerosis. 2001 Jun;156(2):373-8. doi: 10.1016/s0021-9150(00)00664-x. PMID: 11395034. [Accessed 2025 Mar 6]. https://pubmed.ncbi.nlm.nih.gov/11395034/
4. Poznyak AV, Sukhorukov VN, Eremin II, Nadelyaeva II, Orekhov AN. Diagnostics of atherosclerosis: Overview of the existing methods. Front Cardiovasc Med. 2023 May 9;10:1134097. doi: 10.3389/fcvm.2023.1134097. PMID: 37229223; PMCID: PMC10203409. [Accessed 2025 Mar 6]. https://pubmed.ncbi.nlm.nih.gov/37229223/
5. Whayne TF Jr. Atherosclerosis: current status of prevention and treatment. Int J Angiol. 2011 Dec;20(4):213-22. doi: 10.1055/s-0031-1295520. PMID: 23204822; PMCID: PMC3331649. [Accessed 2025 Mar 6]. https://pubmed.ncbi.nlm.nih.gov/23204822/

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