Atherosclerosis, more commonly known as heart disease, is a serious and life-threatening condition. Once you’ve been diagnosed with the disease, you’ll need to make major, lasting lifestyle changes to prevent it from advancing.

But can the disease be reversed? That’s a more complicated question.

The word “atherosclerosis” comes from the Greek words “athero” (“paste”) and “sclerosis” (“hardness”). This is why the condition is also called “hardening of the arteries.”

The disease starts slowly and progresses over time. If you have high cholesterol, the excess cholesterol eventually begins to collect on your artery walls. The body then reacts to the buildup by sending white blood cells to attack it, much like they’d attack a bacterial infection.

The cells die after eating the cholesterol and the dead cells also begin to collect in the artery. This leads to inflammation. When inflammation lasts for a longer period, scarring happens. By this stage, the plaque formed in the arteries has hardened.

When arteries become narrow, blood is unable to get to the areas that it needs to reach. There’s 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, potentially causing a heart attack or stroke.

Large plaque buildups can also dislodge and suddenly send the formerly trapped blood supply to the heart. The sudden rush of blood can stop the heart, causing a deadly heart attack.

Your doctor will note during a regular physical exam if you have risk factors for atherosclerosis. These factors include a history of smoking or conditions such as:

Your doctor may order tests including:

  • Imaging tests. Ultrasound, CT scan, or magnetic resonance angiography (MRA) allow your doctor to see inside your arteries and determine the severity of the blockage.
  • Ankle-brachial index. The blood pressure in your ankles is compared with the blood pressure in your arm. If there’s an unusual difference, you might have peripheral artery disease.
  • Cardiac stress tests. Doctors monitor your heart and breathing while you engage in physical activity, like riding a stationary bike or briskly walking on a treadmill. Since exercise makes your heart work harder, it can help your doctor find a problem.

Dr. Howard Weintraub, cardiologist at NYU Langone Medical Center, says that once you’re diagnosed with atherosclerosis, the most you can do is make the disease less dangerous.

He also explains that “in the studies that have been done so far, the amount of reduction in plaque buildup that’s seen over the course of a year or two is measured in a 100th of a millimeter.”

Medical treatment combined with lifestyle and dietary changes can be used to keep atherosclerosis from getting worse, but they aren’t able to reverse the disease.

Some medications may also be prescribed to increase your comfort, particularly if you’re having chest or leg pain as a symptom.

Statins are the most effective and commonly used cholesterol-lowering drugs in the United States. They work by blocking the substance in your liver that the body uses to make low-density lipoprotein (LDL), or bad cholesterol.

According to Dr. Weintraub, the lower you knock the LDL down, the more likely it is that you’ll get the plaque to stop growing.

There are seven commonly prescribed statins available in the United States:

Healthy dietary changes and regular exercise are both very important parts of reducing high blood pressure and high cholesterol, two major contributors to atherosclerosis. Even if your doctor prescribes a statin, you’ll still need to eat healthy foods and be physically active.

Dr. Weintraub says, “anybody can out eat a medicine that we give them.” He cautions that without the proper diet “the medicine still works, but not as well.”

If you smoke, quit smoking. Smoking causes a buildup of plaque in the arteries. It also reduces the amount of good cholesterol (high-density lipoprotein, or HDL) you have and can raise your blood pressure, which can increase stress on your arteries.

Here are some other lifestyle changes you can make.

Exercise

Aim for 30 to 60 minutes per day of moderate cardio. This amount of activity helps you lose weight, maintain a normal blood pressure, and boost your HDL (good cholesterol) levels.

Dietary changes

Losing weight or maintaining a healthy weight can lower your risk of complications due to atherosclerosis. The following are some ways to do this:

  • Eat more fiber. Replace white breads and pastas with whole grains.
  • Eat lots of fruits and vegetables.
  • Eat healthy fats. Olive oil, avocado, and nuts have fats that won’t raise your LDL levels.
  • Limit dietary cholesterol. Reduce the amount of high-cholesterol foods like cheese, whole milk, and eggs.
  • Avoid trans fats and limit saturated fats. These are mostly found in processed foods, and both cause your body to produce more cholesterol.
  • Limit your sodium intake. Too much sodium in your diet contributes to high blood pressure.
  • Limit your alcohol intake. Drinking regularly can raise your blood pressure and contribute to weight gain. Alcohol is high in calories.

What if medication doesn’t work?

Surgery is considered aggressive treatment and is only done if the blockage is life-threatening and a person hasn’t responded to medication therapy. A surgeon may either remove plaque from an artery or redirect blood flow around the blocked artery.