Atherosclerosis, Explained

Apr 18, 2022


Alto Pharmacy

Arteries are a critical part of your circulatory system, transporting blood and oxygen from the heart to the rest of the body. As you age, a variety of substances collectively referred to as plaque — including fats, cholesterol, and calcium — may accumulate in these blood vessels. A condition called atherosclerosis occurs when the buildup of plaque causes the arteries to narrow and obstructs overall blood flow throughout the body. It is a leading factor in the development of coronary artery disease, the most common type of heart disease.

Many of the key risk factors of atherosclerosis can be managed, and there are effective treatment options that can prevent the condition from worsening. Here’s what to know about causes, symptoms, treatment, and prevention.

What is atherosclerosis?

Atherosclerosis involves slow, progressive changes to the structure of your blood vessels. These changes typically intensify with age. As plaque accumulates, the walls of your arteries become thicker. This gradually narrows the channel within the artery through which blood flows, reducing the amount of oxygen and other nutrients that the rest of your body receives. In some cases, pieces of plaque can break off into the bloodstream and lead to the development of a blood clot.

There are arteries in nearly every part of the body, and three main types of arteries: elastic arteries, muscular arteries, and arterioles.

  • Elastic arteries come out of the heart and contain more elastic tissue than other types of arteries. Their flexibility allows them to receive blood at high pressure. Examples include the pulmonary artery and aorta.

  • Muscular arteries have less elastic tissue and more smooth muscle fiber, which allows them to expand and contract to control the flow of blood. Examples include the coronary and femoral arteries.

  • Arterioles are smaller vessels that branch out from the arteries and help distribute blood into microscopic capillaries.

Atherosclerosis is not limited to a certain area or type of artery. Plaque may develop in arteries in the heart, brain, pelvis, legs, arms, or kidneys. The type of artery affected in atherosclerosis can impact an individual’s symptoms, along with their risk for related health complications.

Different health conditions may arise depending on where plaque accumulates.

  • Coronary artery disease occurs when plaque accumulates in the arteries in or leading to the heart.

  • Angina, a type of chest pain, can also arise from plaque accumulation in the coronary arteries. It results from decreased blood flow to the heart muscle.

  • Carotid artery disease occurs when plaque accumulates in the neck arteries that deliver oxygen-rich blood to the brain.

  • Peripheral artery disease (PAD) occurs when plaque accumulates in the arteries in the arms and legs.

  • Kidney disease occurs when plaque accumulates in the renal arteries, which transport oxygen-rich blood to your kidneys.

In addition to the conditions above, extensive plaque accumulation can lead to other health complications, including heart failure, a heart attack, an abnormal heart rhythm, a stroke, and an aneurysm. Treatment can help slow the progression of atherosclerosis and prevent more serious complications.

Causes of atherosclerosis

Many factors play a role in the development of atherosclerosis, including the following.


Atherosclerosis is among the more common aging-related health issues. Your heart and blood vessels have to work harder as you age. These changes can stiffen the arteries, which makes it easier for plaque to accumulate in them.

High cholesterol levels

Cholesterol is a waxy, fat-like substance that’s produced naturally by the liver and also found in certain foods. It isn’t inherently bad — your body needs a certain amount of cholesterol to produce cell membranes, hormones, and nutrients. However, high levels of low-density lipoprotein (LDL) cholesterol (“bad” cholesterol) can accumulate in the walls of your arteries and turn into plaque, factoring into a person’s risk for heart disease and stroke. (Conversely, a healthy level of high-density lipoprotein (HDL) cholesterol can potentially lower your risk for heart disease.)


Smoking damages your blood vessels and accelerates the buildup of plaque. It is a leading risk factor for peripheral artery disease. 80% of those with PAD are current or former smokers. Smoking is also associated with plaque accumulation in the aorta — the main artery of the body —  and in the coronary arteries.

High blood pressure

High blood pressure strains and damages your coronary arteries, causing them to gradually narrow as plaque accumulates.

Other risk factors

You may have a greater risk for atherosclerosis if you have diabetes or a family history of atherosclerosis. Physical inactivity and obesity also play a role.

Symptoms of atherosclerosis

Atherosclerosis symptoms typically do not appear until an artery has become severely narrow or clogged, to the point where blood flow is affected. There often aren’t noticeable symptoms of mild atherosclerosis. Symptoms of moderate to severe cases vary by the affected artery.

  • Atherosclerosis in coronary arteries: chest pain or pressure

  • Atherosclerosis in the arteries leading to your brain: sudden numbness or weakness in arms or legs, difficulty speaking, confusion, or drooping facial muscles

  • Atherosclerosis in the arteries in your arms and legs: pain in your legs while walking or decreased pressure the affected limb

  • Atherosclerosis in the arteries leading to your kidneys: high blood pressure or weakened kidney function

If you have any concerns about potential symptoms of atherosclerosis, contact your doctor as soon as possible for an evaluation.

Treatment options for atherosclerosis

Atherosclerosis cannot be reversed, but it is treatable. A heart-healthy lifestyle and medications can help slow the accumulation of plaque and prevent the condition from worsening.

Lifestyle changes such as quitting smoking, planning a heart-healthy diet, and exercising more frequently are often a first step in treating mild atherosclerosis. The American Heart Association suggests aiming for about 150 minutes a week of moderate-intensity aerobic activity. Building these healthy habits early on can also help prevent atherosclerosis from developing to begin with.

Your doctor may also recommend medications to prevent atherosclerosis from progressing further. The following medications are commonly used to treat atherosclerosis.

Cholesterol-lowering medications

  • Statins such as atorvastatin and simvastatin act on the liver to prevent LDL cholesterol from forming and limit the overall amount of cholesterol circulating in your bloodstream.

  • Fibrates such as fenofibrate and gemfibrozil can raise HDL cholesterol and lower LDL cholesterol.

  • Niacin is a B vitamin that reduces the liver’s production of blood fats and can lower LDL cholesterol.

For more on cholesterol-lowering medications, read How to Manage High Cholesterol: Diet, Medications, and More.

Blood pressure medications

  • Beta blockers such as metoprolol and carvedilol cause the heart to beat more slowly and less forcefully, lowering your blood pressure.

  • Calcium channel blockers such as amlodipine and diltiazem prevent calcium from entering the smooth muscle cells of the heart and blood vessels, which opens up narrowed blood vessels and lowers blood pressure.

  • ACE inhibitors such as lisinopril and benazepril block production of a hormone called angiotensin II, which causes blood vessels to narrow. This helps constricted blood vessels expand so that more blood can flow through.

  • Angiotensin II receptor blockers (ARBs) such as losartan and valsartan function similarly to ACE inhibitors and protect blood vessels from angiotensin II.

For more on blood pressure medications, read Common Types of Blood Pressure Medications.

Antiplatelet medications

Antiplatelet medications such as aspirin and clopidogrel may be prescribed to reduce your risk of blood clots.

Surgery may be necessary to treat severe cases of atherosclerosis, or if there is risk of serious damage to your muscle or skin tissue.

Take charge of your health

At Alto, we make it as simple as possible to manage your risk for chronic health conditions and to stay on top of your cholesterol-lowering or blood pressure medications. We will work with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to ensure your medications are as affordable as possible. And our team of pharmacists is available to chat whenever questions come up about side effects or how to take your medication properly.

Reach out any time via phone at 1-800-874-5881, or in-app messaging.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

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