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Hardening of the arteries

Atherosclerosis; Arteriosclerosis; Plaque buildup - arteries; Hyperlipidemia - atherosclerosis; Cholesterol - atherosclerosis

 

Hardening of the arteries, also called atherosclerosis, occurs when fat, cholesterol, and other substances build up in the walls of arteries. These deposits are called plaques. Over time, these plaques can narrow or completely block the arteries and cause problems throughout the body.

Hardening of the arteries is a common disorder.

Causes

 

Hardening of the arteries often occurs with aging. As you grow older, plaque buildup narrows your arteries and makes them stiffer. These changes make it harder for blood to flow through them.

Clots may form in these narrowed arteries and block blood flow. Pieces of plaque can also break off and move to smaller blood vessels, blocking them.

These blockages starve tissues of blood and oxygen. This can result in damage or tissue death. It is a common cause of heart attack and stroke.

High blood cholesterol levels can cause hardening of the arteries at a younger age.

For many people, high cholesterol levels are due to a diet that is too high in saturated fats and trans fats.

Other factors that can contribute to hardening of the arteries include:

  • Diabetes
  • Family history of hardening of the arteries
  • High blood pressure
  • Lack of exercise
  • Being overweight or obese
  • Smoking

 

Symptoms

 

Hardening of the arteries does not cause symptoms until blood flow to part of the body becomes slowed or blocked.

If the arteries supplying the heart become narrow, blood flow can slow down or stop. This can cause chest pain (stable angina), shortness of breath, and other symptoms.

Narrowed or blocked arteries may also cause problems in the intestines, kidneys, legs, and brain.

 

Exams and Tests

 

A health care provider will perform a physical exam and listen to the heart and lungs with a stethoscope. Hardening of the arteries can create a whooshing or blowing sound ("bruit") over an artery.

Screening for high blood pressure is recommended for all adults who are at least 18 years old. Additional screening recommendations include:

  • Once a year for adults beginning at age 40 years and for persons at increased risk for high blood pressure. Increased risks include people with high-normal blood pressure (130-139/85-89mmHg), people who are overweight or obese, and African Americans.
  • Screening every 3 to 5 years for adults 18 to 39 years old with blood pressure less than 130/85mmHg who do not have other risk factors.

Cholesterol testing is recommended in all adults. The major national guidelines differ on the suggested age to start testing.

  • Screening should begin between ages 20 to 35 for men and ages 20 to 45 for women.
  • Repeat testing is not needed for five years for most adults with normal cholesterol levels.
  • Repeat testing may be needed if lifestyle changes occur, such as large increase in weight or a change in diet.
  • More frequent testing is needed for adults with a history of high cholesterol, diabetes, kidney problems, heart disease, stroke, and other conditions

A number of imaging tests may be used to see how well blood moves through your arteries.

  • Doppler tests that use ultrasound or sound waves
  • Magnetic resonance arteriography (MRA), a special type of MRI scan
  • Special CT scans called CT angiography
  • Arteriograms or angiography that use x-rays and contrast material (sometimes called "dye") to see the path of blood flow inside the arteries

 

Treatment

 

Lifestyle changes will reduce your risk of hardening of the arteries. Things you can do include:

  • Quit smoking : This is the single most important change you can make to reduce your risk of heart disease and stroke.
  • Avoid fatty foods: Eat well-balanced meals that are low in fat and cholesterol. Include several daily servings of fruits and vegetables. Adding fish to your diet at least twice a week may be helpful. However, do not eat fried fish.
  • Limit how much alcohol you drink: Recommended limits are one drink a day for women, two a day for men.
  • Get regular physical activity: Exercise with moderate intensity (such as brisk walking) 5 days a week for 30 minutes a day if you are at a healthy weight. For weight loss, exercise for 60 to 90 minutes a day. Talk to your provider before starting a new exercise plan, especially if you have been diagnosed with heart disease or you have ever had a heart attack.

If your blood pressure is high, it is important for you to lower it and keep it under control.

  • Most people should keep their blood pressure below 140/90 mmHg. However, your provider may recommend a different target depending on your age and other health conditions.
  • If you have diabetes, kidney disease, or have had a stroke or heart attack, your blood pressure may need to be lower. Ask your provider what your blood pressure should be.
  • Do not stop or change high blood pressure medicines without talking to your provider.

Your provider may want you to take medicine for abnormal cholesterol levels or for high blood pressure if lifestyle changes do not work. This will depend on:

  • Your age
  • Whether you have heart disease or other blood flow problems
  • Whether you smoke or are overweight
  • Whether you have diabetes or other heart disease risk factors

Your provider may suggest taking aspirin or another medicine to help prevent blood clots from forming in your arteries. These medicines are called antiplatelet drugs. DO NOT take aspirin without first talking to your provider.

Losing weight if you are overweight and reducing blood sugar if you have diabetes or pre-diabetes can help reduce the risk of developing atherosclerosis.

 

Outlook (Prognosis)

 

Hardening of the arteries cannot be reversed once it has occurred. However, lifestyle changes and treating high cholesterol levels can prevent or slow the process from becoming worse. This can help reduce the chances of having a heart attack and stroke as a result of atherosclerosis.

 

Possible Complications

 

In some cases, the plaque is part of a process that causes a weakening of the wall of an artery. This can lead to a bulge in an artery called an aneurysm . Aneurysms can break open (rupture). This causes bleeding that can be life threatening.

 

 

Open References

References

Ettehad D, Emdin CA, Kiran A, et al. Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet . 2016;387(10022):957-967. PMID: 26724178 www.ncbi.nlm.nih.gov/pubmed/26724178 .

Genest J, Libby P. Lipoprotein disorders and cardiovascular disease. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 45.

Hansson GK, Hamsten A. Atherosclerosis, thrombosis, and vascular biology. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 70.

Libby P. The vascular biology of atherosclerosis. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 41.

Siu AL, on behalf of the US Preventive Services Task Force. Screening for high blood pressure in adults. US Preventive Services Task Force Recommendation Statement. Ann Intern Med . 2015;163:778-786.

US Preventive Services Task Force Draft Recommendation Statement. Statin use for the primary prevention of cardiovascular disease in adults: preventive medication. www.uspreventiveservicestaskforce.org/Page/Document/draft-recommendation-statement175/statin-use-in-adults-preventive-medication1 . Accessed June 3, 2016.

US Preventive Services Task Force Topic Page. Screening for lipid disorders in adults. www.uspreventiveservicestaskforce.org/uspstf/uspschol.htm . Accessed May 13, 2014.

 
  • Hardening of arteries

    Hardening of arteries

    Animation

    •  

    Hardening of arteries - Animation

    Blood is the fuel that keeps your body alive and working. It’s your blood that transports the oxygen your cells need to survive. To get to your heart and out the rest of your body, blood needs a clear pathway through your arteries. But as you get older - and if you eat too many French fries and cheeseburgers - your arteries can harden and narrow, fill with plaque, leaving less room for blood to flow through. Let’s talk today about atherosclerosis. Your arteries are like the pipes your water flows through to get to your bathroom sink. When the pipes are clear, water flows easily through them. But when minerals, rust, and other debris get stuck in the pipes, it clogs them up, leaving less room for water to flow through. That’s why you get nothing more than a drip when you turn on your bathroom sink. In your arteries, clogs are caused by plaque. Plaque is a substance made up of fat and cholesterol, which are found in unhealthy foods like those French fries and also bacon. Because plaque is sticky, it collects on your artery walls and blocks the flow of blood. Sometimes a clump of plaque breaks off and floats away to a smaller blood vessel leading to your heart or brain. If it gets stuck in that vessel, you can have a heart attack or stroke. Or, the plaque can weaken an artery wall, which is called an aneurysm. If that aneurysm breaks open, you could have a very life-threatening bleeding. How can you tell if you have atherosclerosis? Well, that’s the tricky part, because often atherosclerosis doesn’t cause any symptoms until you’ve got a blocked artery. And by then, you could already be having a heart attack or stroke. So that you don’t discover the problem too late, see your doctor for regular check-ups. Get your cholesterol screened by age 35 if you’re a man, age 45 if you’re a woman. Also have your blood pressure checked every 1 to 2 years before age 50, and then once a year after that. You may need to have your blood pressure checked even more often if you have high blood pressure, heart disease, or you’ve already had a stroke. Although you can’t reverse atherosclerosis once it starts, you can prevent it with some easy lifestyle changes. Eat a balanced diet that’s high in heart-healthy fruits, vegetables, and fish. Exercise for at least 30 to 60 minutes a day. Stop smoking, cause that’s really bad news for your arteries. If your cholesterol is high, ask your doctor whether you should take cholesterol-lowering medication. Lastly, you may also need to take aspirin or another blood-thinning drug to prevent clots from forming in your arteries.

  • Atherosclerosis Causes

    Atherosclerosis Causes

    Animation

    •  

    Atherosclerosis Causes - Animation

    Facts, risk factors, causes and treatment of atherosclerosis.

  • Atherosclerosis

    Animation

    •  

    Atherosclerosis - Animation

    Normally, the walls of an artery are smooth, allowing blood to flow unimpeded. Atherosclerosis is when harmful material collects on the wall of an artery. This material includes fat, cholesterol, and other substances. Eventually, the material builds up and a plaque is formed, narrowing the artery. When the build-up is severe, a clot could block the vessel completely.

  • Carotid stenosis, X-ray of the left artery

    Carotid stenosis, X-ray of the left artery - illustration

    A carotid arteriogram is an x-ray study designed to determine if there is narrowing or other abnormality in the carotid artery, a main artery to the brain. This is an angiogram of the left common carotid artery (both front-to-back and side views) showing a severe narrowing (stenosis) of the internal carotid artery just beyond the division of the common carotid artery into the internal and external branches.

    Carotid stenosis, X-ray of the left artery

    illustration

  • Carotid stenosis, X-ray of the right artery

    Carotid stenosis, X-ray of the right artery - illustration

    This is an angiogram of the right carotid artery showing a severe narrowing (stenosis) of the internal carotid artery just past the carotid fork. There is enlargement of the artery or ulceration in the area after the stenosis in this close-up film. Note the narrowed segment toward the bottom of the picture.

    Carotid stenosis, X-ray of the right artery

    illustration

  • Enlarged view of atherosclerosis

    Enlarged view of atherosclerosis - illustration

    Atherosclerosis is a disease of the arteries in which fatty material and plaque are deposited in the wall of an artery, resulting in narrowing of the arterial lumen and eventual impairment of blood flow.

    Enlarged view of atherosclerosis

    illustration

  • Prevention of heart disease

    Prevention of heart disease - illustration

    Heart disease may be prevented by recommended healthy diet, regular exercise and to stop smoking if you are a smoker. Follow your health care provider's recommendations for treatment and prevention of heart disease.

    Prevention of heart disease

    illustration

  • Developmental process of atherosclerosis

    Developmental process of atherosclerosis - illustration

    The development of arterial atherosclerosis may occur when deposits of cholesterol and plaque accumulate at a tear in the inner lining of an artery. As the deposits harden and occlude the arterial lumen, blood flow to distant tissues decreases and a clot may become lodged, completely blocking the artery.

    Developmental process of atherosclerosis

    illustration

  • Angina

    Angina - illustration

    Angina is a specific type of pain in the chest caused by inadequate blood flow through the blood vessels (coronary vessels) of the heart muscle (myocardium).

    Angina

    illustration

  • Atherosclerosis

    Atherosclerosis - illustration

    Atherosclerosis is a disease of the arteries in which fatty material is deposited in the vessel wall, resulting in narrowing and eventual impairment of blood flow. Severely restricted blood flow in the arteries to the heart muscle leads to symptoms such as chest pain. Atherosclerosis shows no symptoms until a complication occurs.

    Atherosclerosis

    illustration

  • Cholesterol producers

    Cholesterol producers - illustration

    Cholesterol is a waxy, fat-like material that is found in all parts of the body. It comes from two sources: our liver produces it, and we consume it in meat and dairy products.

    Cholesterol producers

    illustration

  • Coronary artery balloon angioplasty - Series

    Coronary artery balloon angioplasty - Series

    Presentation

    •  

  • Hardening of arteries

    Animation

    •  

    Hardening of arteries - Animation

    Blood is the fuel that keeps your body alive and working. It’s your blood that transports the oxygen your cells need to survive. To get to your heart and out the rest of your body, blood needs a clear pathway through your arteries. But as you get older - and if you eat too many French fries and cheeseburgers - your arteries can harden and narrow, fill with plaque, leaving less room for blood to flow through. Let’s talk today about atherosclerosis. Your arteries are like the pipes your water flows through to get to your bathroom sink. When the pipes are clear, water flows easily through them. But when minerals, rust, and other debris get stuck in the pipes, it clogs them up, leaving less room for water to flow through. That’s why you get nothing more than a drip when you turn on your bathroom sink. In your arteries, clogs are caused by plaque. Plaque is a substance made up of fat and cholesterol, which are found in unhealthy foods like those French fries and also bacon. Because plaque is sticky, it collects on your artery walls and blocks the flow of blood. Sometimes a clump of plaque breaks off and floats away to a smaller blood vessel leading to your heart or brain. If it gets stuck in that vessel, you can have a heart attack or stroke. Or, the plaque can weaken an artery wall, which is called an aneurysm. If that aneurysm breaks open, you could have a very life-threatening bleeding. How can you tell if you have atherosclerosis? Well, that’s the tricky part, because often atherosclerosis doesn’t cause any symptoms until you’ve got a blocked artery. And by then, you could already be having a heart attack or stroke. So that you don’t discover the problem too late, see your doctor for regular check-ups. Get your cholesterol screened by age 35 if you’re a man, age 45 if you’re a woman. Also have your blood pressure checked every 1 to 2 years before age 50, and then once a year after that. You may need to have your blood pressure checked even more often if you have high blood pressure, heart disease, or you’ve already had a stroke. Although you can’t reverse atherosclerosis once it starts, you can prevent it with some easy lifestyle changes. Eat a balanced diet that’s high in heart-healthy fruits, vegetables, and fish. Exercise for at least 30 to 60 minutes a day. Stop smoking, cause that’s really bad news for your arteries. If your cholesterol is high, ask your doctor whether you should take cholesterol-lowering medication. Lastly, you may also need to take aspirin or another blood-thinning drug to prevent clots from forming in your arteries.

  • Atherosclerosis Causes

    Animation

    •  

    Atherosclerosis Causes - Animation

    Facts, risk factors, causes and treatment of atherosclerosis.

  • Atherosclerosis

    Animation

    •  

    Atherosclerosis - Animation

    Normally, the walls of an artery are smooth, allowing blood to flow unimpeded. Atherosclerosis is when harmful material collects on the wall of an artery. This material includes fat, cholesterol, and other substances. Eventually, the material builds up and a plaque is formed, narrowing the artery. When the build-up is severe, a clot could block the vessel completely.

  • Carotid stenosis, X-ray of the left artery

    Carotid stenosis, X-ray of the left artery - illustration

    A carotid arteriogram is an x-ray study designed to determine if there is narrowing or other abnormality in the carotid artery, a main artery to the brain. This is an angiogram of the left common carotid artery (both front-to-back and side views) showing a severe narrowing (stenosis) of the internal carotid artery just beyond the division of the common carotid artery into the internal and external branches.

    Carotid stenosis, X-ray of the left artery

    illustration

  • Carotid stenosis, X-ray of the right artery

    Carotid stenosis, X-ray of the right artery - illustration

    This is an angiogram of the right carotid artery showing a severe narrowing (stenosis) of the internal carotid artery just past the carotid fork. There is enlargement of the artery or ulceration in the area after the stenosis in this close-up film. Note the narrowed segment toward the bottom of the picture.

    Carotid stenosis, X-ray of the right artery

    illustration

  • Enlarged view of atherosclerosis

    Enlarged view of atherosclerosis - illustration

    Atherosclerosis is a disease of the arteries in which fatty material and plaque are deposited in the wall of an artery, resulting in narrowing of the arterial lumen and eventual impairment of blood flow.

    Enlarged view of atherosclerosis

    illustration

  • Prevention of heart disease

    Prevention of heart disease - illustration

    Heart disease may be prevented by recommended healthy diet, regular exercise and to stop smoking if you are a smoker. Follow your health care provider's recommendations for treatment and prevention of heart disease.

    Prevention of heart disease

    illustration

  • Developmental process of atherosclerosis

    Developmental process of atherosclerosis - illustration

    The development of arterial atherosclerosis may occur when deposits of cholesterol and plaque accumulate at a tear in the inner lining of an artery. As the deposits harden and occlude the arterial lumen, blood flow to distant tissues decreases and a clot may become lodged, completely blocking the artery.

    Developmental process of atherosclerosis

    illustration

  • Angina

    Angina - illustration

    Angina is a specific type of pain in the chest caused by inadequate blood flow through the blood vessels (coronary vessels) of the heart muscle (myocardium).

    Angina

    illustration

  • Atherosclerosis

    Atherosclerosis - illustration

    Atherosclerosis is a disease of the arteries in which fatty material is deposited in the vessel wall, resulting in narrowing and eventual impairment of blood flow. Severely restricted blood flow in the arteries to the heart muscle leads to symptoms such as chest pain. Atherosclerosis shows no symptoms until a complication occurs.

    Atherosclerosis

    illustration

  • Cholesterol producers

    Cholesterol producers - illustration

    Cholesterol is a waxy, fat-like material that is found in all parts of the body. It comes from two sources: our liver produces it, and we consume it in meat and dairy products.

    Cholesterol producers

    illustration

  •   Coronary artery balloon angioplasty - Series

    Coronary artery balloon angioplasty - Series

    Presentation

    •  

A Closer Look

 

    Talking to your MD

     

      Self Care

       

        Tests for Hardening of the arteries

         
           

          Review Date: 2/24/2016

          Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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