Arteries are blood vessels that carry blood to the heart so that it can be pumped throughout the body. The inner walls of the arteries are supposed to be smooth, but as you age, a sticky substance known as plaque can build up on the walls of the arteries. This makes it harder for blood to move through them.

Plaque in the arteries is known as atherosclerosis. If left untreated, atherosclerosis can cause a heart attack, stroke, or other serious conditions.

Cholesterol, a type of fat or lipid, is a key component of plaque. We produce cholesterol naturally in our bodies and also get it from the foods we eat.

You’ve likely heard plenty of warnings about cholesterol being bad for you. But cholesterol isn’t always bad. It’s needed for your body to produce hormones, create new cells, and make chemicals that aid your digestion.

Problems occur when you have too much cholesterol circulating around the blood.

The good news is that there are ways to change your diet and medications that you can take to keep cholesterol from building up in the arteries.

For most people, high cholesterol levels in the blood are caused by a diet high in saturated fats, cholesterol, and trans fats. These types of fats are in foods that are often considered “unhealthy” such as deep-fried foods, fast food, processed meat, full-fat dairy, baked goods, and sweets.

Your genetics can also affect your chances of developing high cholesterol. If your parents have high cholesterol, you may be at a greater risk of having it. High cholesterol can also be caused by a genetic disorder known as familial hypercholesterolemia, but this is rare.

High cholesterol is very common in the United States. The Centers for Disease Control and Prevention (CDC) estimates that nearly 94 million adults ages 20 or older have what could be considered borderline high cholesterol.

Researchers aren’t exactly clear on how the process of plaque buildup starts, but they believe it begins with damage or inflammation in the artery. Once that damage occurs, high cholesterol floating in the blood can start getting stuck in the arteries along with a few other substances. This is called plaque.

An illustration of how plaque can build up in the arteries. Share on Pinterest
Medical Illustration by Bailey Mariner

Plaque is made up of:

  • calcium
  • fat
  • cholesterol
  • cellular waste
  • fibrin (a substance your body uses to help blood clot)

Cholesterol plays a major role in forming plaque. Cholesterol moves around the blood via substances known as lipoproteins.

Low-density lipoprotein (LDL), sometimes called “bad cholesterol,” is the major contributor to arterial plaque. On the other hand, high-density lipoprotein (HDL), or “good cholesterol,” is thought to remove some of the bad cholesterol from plaque in clogged arteries. Having high amounts of bad cholesterol and low amounts of good cholesterol is considered the perfect recipe for atherosclerosis.

There are a few other factors that are known to accelerate the rate of plaque buildup in the arteries. These include:

Age is also a factor. As you get older, your arteries tend to stiffen and become less elastic. This makes them more susceptible to plaque buildup.

As the plaque grows, it sets off a chain of reactions in the body leading to more inflammation and more plaque.

At what age do arteries start to clog?

The arteries can start to clog with plaque as early as your childhood.

Early stages of atherosclerosis can begin to appear in children younger than 10. The plaque buildup tends to worsen in our 20s and 30s and can build up rapidly in our 40s and 50s. In men, the risk increases after age 45. In women, the risk tends to increase after age 55.

You probably won’t experience any symptoms of clogged arteries until the condition becomes serious or it results in a heart attack or stroke.

If an artery of the heart is severely blocked, you might experience the following symptoms:

If a blood vessel in the brain is blocked, you may experience symptoms of stroke such as:

If you’re experiencing any of these symptoms, get medical attention as soon as possible.

The best test to check for clogged arteries of the heart is called a cardiac angiogram. This is a type of chest X-ray that’s taken after your heart arteries are injected with a mildly radioactive dye. It’s considered to be the best method of diagnosing conditions that affect the arteries surrounding the heart. With this type of imaging test, a doctor or healthcare professional can see if there’s a blockage in any of your arteries.

But before doing any imaging, a doctor will likely conduct a physical exam to see if you have any signs that your blood isn’t flowing the way it’s supposed to. For example, a weak pulse or wounds that heal slowly could mean your blood flow is restricted.

A cardiologist (a doctor that specializes in treating conditions of the heart) may listen to your heart to see if there are any abnormal sounds like a heart murmur or bruit (the name of a swishing sound the blood makes as it moves through a blocked artery).

If a doctor suspects you have atherosclerosis, they’ll likely order a cardiac angiogram or other tests to help confirm the diagnosis. These tests include:

  • electrocardiogram, a test to record your heart’s electrical activity
  • echocardiogram, an important test to study the function of your heart and show abnormalities and effects of clogged arteries
  • computed tomography angiography, a noninvasive imaging test that produces an image of the inside of the arteries
  • doppler ultrasound, an imaging test that uses high frequency sound waves to help see the flow of blood in the arteries and can help determine if you have peripheral vascular disease
  • magnetic resonance angiography, a test to help visualize problems with the blood flow in the heart or arteries

A doctor will likely also take a sample of blood to find out if you have high cholesterol and measure your blood pressure. They may also do a stress test to help understand how the heart responds to exercise. This test is also known as an exercise tolerance test. It’s used to record the heart’s electrical activity while you engage in physical activity. For those unable to exercise, a nuclear stress test may be used.

Making heart-healthy changes to your diet isn’t easy, but it’s worth it. It’s important to take it day by day and try to incorporate positive changes into your lifestyle slowly and permanently. It’s not about focusing on avoiding one “bad” food or never eating sweets again but instead changing your overall diet.

In general, here are a few diet and lifestyle changes you can make to help prevent plaque buildup in your arteries:

And here are a few other tips:

A doctor may prescribe medications to help lower high blood pressure and cholesterol. Some examples are:

If your artery is severely blocked, surgery may be needed to prevent heart attacks or strokes. A surgeon can remove plaque from an artery or redirect blood flow around the blocked artery.

Living with high cholesterol

If you have high cholesterol, it’s important to start taking action to lower it. Without treatment, high cholesterol can cause plaque to build up in your arteries and lead to heart disease and other serious issues.

Just because you have high cholesterol doesn’t mean you have to take medication. A doctor might first have you try to make changes to your diet or lifestyle before writing a prescription.

If you’re struggling to change your diet or lifestyle because of stress, anxiety, depression, or substance misuse, you may want to ask for help from a trained psychologist or psychiatrist. Nowadays, it’s much easier to talk with a therapist online in the comfort of your own home.

You may also benefit from joining a support group for people also living with high cholesterol:

  • The National Lipid Association hosts a collection of different support groups for those with high cholesterol from a variety of demographics.
  • Family Heart Foundation offers support to those with high cholesterol, familial hypercholesterolemia, and their caregivers.
  • The American Heart Association provides information on keeping your heart healthy and can connect you with support groups as well.
  • At ClinicalTrials.gov, you can search for ongoing trials around high cholesterol and its treatments, but make sure to talk with a doctor before applying.

When plaque builds up in the arteries, it can harden and block off the artery. This can stop the blood flow through the arteries and cause heart disease, stroke, peripheral artery disease, or heart attacks.

You might not have any symptoms of high cholesterol or plaque buildup until the condition becomes serious. It’s important that you see a doctor regularly for wellness checkups to learn if you’re at risk of heart disease.

Though the American Heart Association recommends that adults have their cholesterol levels checked at least once every 4 to 6 years, if you already have high cholesterol or you have certain risk factors, a doctor will encourage you to get your cholesterol levels tested more often.