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Atherosclerosis is a common health condition caused by the buildup of fats, cholesterol, and blood cells in your arteries. This buildup is called plaque, and it can block blood flow through your arteries and increase your blood pressure. Treatments for atherosclerosis help lower cholesterol levels and blood pressure while also addressing symptoms of the condition. In some cases, surgery may be performed to open or bypass blocked arteries.
Depending on your case of atherosclerosis, your doctor may recommend a combination of medication, surgery, or lifestyle changes. Together, these treatments can help you live a healthier life and lower your risk of other complications (such as a stroke or heart attack).
Atherosclerosis develops when plaque prevents blood from properly flowing through your arteries. These blood vessels carry oxygen-rich blood from your heart to other parts of your body.
Almost every artery throughout your body can be affected by atherosclerosis. There are several different diseases caused by atherosclerosis, including:
Atherosclerosis can be caused by genetics, lifestyle factors, or a combination of both. If a family member has the disease, you may be more likely to develop it. Certain genes that cause cholesterol disorders also increase your risk of atherosclerosis.
Other risk factors include older age, having another inflammatory disease, and lifestyle habits such as smoking, eating a diet high in sugar and fat, and being inactive. High blood sugar levels from diabetes and high blood pressure levels can also damage your artery walls, leading to plaque buildup.
The symptoms of atherosclerosis are different depending on which arteries are affected. You may experience leg aches, pain, and cramping with peripheral artery disease. On the other hand, coronary artery disease is associated with dizziness, shortness of breath, rapid heartbeat, and angina (chest pain).
Plaque can also break off into your bloodstream and form blood clots, which puts you at risk for a heart attack or stroke.
Your doctor may prescribe one or more medications to treat different factors contributing to atherosclerosis. Some help lower cholesterol or blood pressure levels, and others help manage your symptoms.
Statins help lower levels of “bad” cholesterol, known as low-density lipoprotein (LDL cholesterol). This type of cholesterol is responsible for forming plaques in your arteries. Some statins also help raise “good” cholesterol levels, or high-density lipoprotein (HDL cholesterol), which helps your body get rid of extra cholesterol.
Examples of statins for atherosclerosis include:
If you have atherosclerosis, your heart has to work harder to pump blood through narrowed arteries. Eventually, this extra work can lead to heart failure. Your doctor may prescribe beta-blockers or ACE inhibitors to help lower your blood pressure, ease the workload on your heart, and lessen chest pain.
Beta-blockers help your blood vessels relax. This lowers your blood pressure because more blood can flow through a larger, relaxed artery. Beta-blockers also lower your heart rate, allowing your heart to be more relaxed. Examples of beta-blockers include:
ACE enzymes normally help tighten your blood vessels. ACE inhibitors block these proteins to help relax your blood vessels. Your doctor may prescribe:
The cells that make up your heart and blood vessels use calcium to strengthen muscle contractions. This causes your arteries to narrow, which increases blood pressure. Calcium channel blockers prevent these cells from using calcium and relax your blood vessels. These medications also help treat chest pain.
Examples of calcium channel blockers include:
High blood sugar levels from diabetes can damage your arteries, leading to inflammation. This triggers cholesterol and blood cells to stick to the artery walls, forming plaque. If you have diabetes, some of your medications may also help treat atherosclerosis. Metformin (Glucophage) helps reduce plaque buildup.
The U.S. Food and Drug Administration (FDA) has also approved two other diabetes medications for treating heart disease. Liraglutide (Victoza) helps your pancreas release the hormone insulin, which your cells need to take up glucose (sugar) as fuel. This lowers your blood sugar levels.
Empagliflozin (Jardiance) helps your body get rid of extra glucose through your urine. This lowers both your blood sugar and blood pressure levels, which can help manage atherosclerosis.
If a piece of plaque breaks off into your bloodstream, it can form a blood clot with platelets and other blood cells. The blood clot may travel to your heart or brain, triggering a heart attack or stroke. Blood thinners and antiplatelet drugs help prevent clots from forming, lowering your risk of complications from atherosclerosis.
Common blood thinners include:
Antiplatelet drugs include aspirin, clopidogrel (Plavix), and ticagrelor (Brilinta).
If medications aren’t enough to treat atherosclerosis, procedures and surgery can help open blocked arteries. A stent (thin mesh tube) can be placed nonsurgically inside an artery to prevent it from closing again. Some surgeries create new pathways for blood to flow around blocked arteries.
A coronary angioplasty is a procedure that opens blocked arteries in the heart. During the procedure, a cardiologist inserts a long, thin, flexible tube known as a catheter into an artery in your arm or groin. The tip of the catheter has a balloon on it — when it reaches the blockage, the balloon is inflated to stretch it out. The cardiologist may also put a stent in the artery to prevent it from narrowing again.
If you have blocked carotid arteries in your neck, your doctor may recommend a carotid endarterectomy. During this procedure, a surgeon will make a small incision in your neck to open your artery. They’ll then remove plaque that has built up inside. The artery is closed with stitches or a patch made from synthetic material or a vein.
A coronary artery bypass graft (CABG, pronounced “cabbage”) is an open-heart surgery procedure used to treat coronary artery disease. Typically, this intensive procedure is only used to treat severe atherosclerosis in the heart’s arteries. Although CABG doesn’t cure coronary artery disease, it can help relieve symptoms and reduce your risk of other complications.
A CABG “bypasses” the blocked artery in your heart with another blood vessel. The surgeon will take a blood vessel from another part of your body, such as your arm or leg, to use in the procedure.
In addition to suggesting medications and surgery, your doctor will likely recommend lifestyle changes you can make to improve your overall health.
You can follow a heart-healthy diet that’s low in salt and saturated fats to help keep your cholesterol levels in check. Try choosing whole grains, fruits, vegetables, and lean meats.
Regular physical activity can also help treat atherosclerosis. Just 30 minutes of aerobic exercise a few times a week can lower your blood pressure and cholesterol and help you maintain a healthy weight. You can try walking, biking, or swimming.
It isn’t currently possible to fully reverse damage caused by atherosclerosis. However, studies show you can slow or stop the progression of atherosclerosis through healthy lifestyle changes and medications that lower your blood pressure, cholesterol, and blood sugar levels. If you’d like to learn more about how to make these changes, talk to your doctor.
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Steven Kang, M.D.
is the Director of Cardiac Electrophysiology at Alta Bates Summit Medical Center and Alameda Health Systems in Oakland, California.
Learn more about him here.
Emily Wagner, M.S.
holds a Master of Science in biomedical sciences with a focus in pharmacology. She is passionate about immunology, cancer biology, and molecular biology.
Learn more about her here.
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