Most people don’t experience the life-threatening complications of having atherosclerosis — hardening of the arteries — until they reach middle age. However, the beginning stages can actually start during childhood. The disease tends to be progressive, and gets worse over time.

Over time, plaque, which is made of fatty cells (cholesterol), calcium, and other waste products, builds up in a major artery. The artery becomes more and more narrow, which means blood is unable to reach areas it needs to. There is also a higher risk that if a blood clot breaks away from another area in the body, it could get stuck in the narrow artery and cut off blood supply completely, causing a heart attack or stroke.

What Causes It?

Atherosclerosis is a complex condition, generally starting early in life and progressing as people get older. Studies have found that children as young as 10 to 14 can show the early stages of atherosclerosis. For some people, the disease advances quickly in their 20s and 30s, while others may not have issues until their 50s or 60s.

Researchers aren’t exactly sure how or why it begins. It’s believed that plaque starts to build up in arteries after the lining becomes damaged. The most common contributors to this damage are high cholesterol, high blood pressure, and smoking cigarettes.

What Are the Risks?

Your arteries carry oxygenated blood to vital organs like your heart, brain, and kidneys. If the path becomes blocked, these parts of your body can’t function the way they’re supposed to. How your body is affected depends on which arteries are blocked.

These are the diseases related to atherosclerosis:

  • Heart disease, when plaque builds up in your coronary arteries, which are the large vessels that carry blood to your heart. This puts you at increased risk for a heart attack.
  • Carotid artery disease, when plaque builds up in the large vessels on either side of your neck (carotid arteries) that carry blood to your brain. This puts you at higher risk of having a stroke.
  • Peripheral artery disease, when plaque builds up in the large arteries that carry blood to your arms and legs. This causes pain, numbness, and can lead to serious infections.
  • Kidney disease, when plaque builds up in the large arteries that carry blood to your kidneys. When your kidneys can’t function properly, they can’t remove waste from your body, leading to serious complications.

How Do You Get Tested?

If you have symptoms, like a weak pulse near a major artery, lower blood pressure near an arm or leg, or signs of an aneurysm, your doctor may notice them during a regular physical exam. Results from a blood test can tell the doctor if you have high cholesterol.

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Other, more involved tests include:

  • Imaging tests: An ultrasound, computerized tomography (CT) scan, or magnetic resonance angiography (MRA) will allow doctors to see inside the arteries and tell how severe blockages are.
  • Ankle-brachial index: The blood pressure in your ankles is compared with your arm. If there is an unusual difference, it can point to peripheral artery disease.
  • Stress test: Doctors can monitor your heart and breathing while you engage in physical activity, like riding on a stationary bike or briskly walking on a treadmill. Since exercise makes your heart work harder, it can help doctors discover a problem.

What Lifestyle Changes Can Help?

Healthy dietary changes, stopping smoking, and exercise can be powerful weapons against high blood pressure and high cholesterol, two major contributors to atherosclerosis.


Physical activity helps you lose weight, maintain a normal blood pressure, and boosts your “good cholesterol” (HDL) levels. Aim for 30 to 60 minutes a day of moderate cardio.


Maintain a healthy weight by eating more fiber; this can be achieved by replacing white breads and pastas with foods made out of whole grains. Also eat lots of fruits and vegetables, as well as healthy fats — olive oil, avocado, and nuts all have fats that won’t raise your “bad cholesterol” (LDL).

Limit your cholesterol intake by reducing the amount of high cholesterol foods you eat, like cheese, whole milk, and eggs. Also avoid trans fats and limit saturated fats (mostly found in processed foods), as both cause your body to produce more cholesterol.

You should also limit your sodium intake, as this contributes to high blood pressure, as well as alcohol. Drinking regularly can raise your blood pressure and contribute to weight gain (alcohol is high in calories).

These habits are best to start early in life, but they’re beneficial no matter how old you are.

Can It Be Treated?

If atherosclerosis has progressed beyond what lifestyle changes can reduce, there are medications and surgical treatments available. These are designed to prevent the disease from getting worse and to increase your comfort, particularly if you’re having chest or leg pain as a symptom.

Medications typically include drugs to treat high blood pressure and high cholesterol. Some examples are:

  • statins
  • beta blockers
  • angiotensin-converting enzyme (ACE) inhibitors
  • antiplatelets
  • calcium channel blockers

Surgery is considered a more aggressive treatment and is done if the blockage is life-threatening. A surgeon may go in and remove plaque from an artery, or redirect blood flow around the blocked artery.