Atherosclerosis

What is atherosclerosis?

Atherosclerosis is when your arteries (the tubes which send blood around your body) become clogged. It’s a slow process that can begin from when you’re young. 

Fatty substances and blood components (the ingredients that make up your blood like white and red blood cells) build up in your arteries. This is called plaque, or atheroma. It can increase over time and prevent your blood from flowing as it should, which can cause serious health problems.

Atherosclerosis can happen to anyone. But it’s more likely if you’re older, smoke, have an unhealthy diet, or have a family history of atherosclerosis. 

Having an African, African-Caribbean, or Asian background can also increase your chances of developing atherosclerosis.

You can check your cholesterol levels at home with a cholesterol blood test.

What causes atherosclerosis?

Experts aren’t entirely sure what causes atherosclerosis. But they know it’s a complex process that involves the inner walls of your arteries, inflammation, and various blood components. 

Inflammation can happen when the inner layer of your arteries becomes damaged. This can be caused by things like high blood pressure (hypotension), diabetes, and smoking. When your arteries become damaged, your immune system kicks in to protect and heal them. This causes blood cells and other substances to build up where the injury is and clump together.  

This can eventually make your arteries become stiff and narrow, which means your organs might not get enough blood to function properly.  

These buildups can eventually spill the contents into your blood, or parts can break off and enter your bloodstream. This can cause a clot, which blocks off an artery and the blood flow to a part of your body.  

This is what happens in a heart attack — one of your heart vessels gets blocked, and this cuts off blood supply to your heart.

Atherosclerosis symptoms

Atherosclerosis doesn’t have symptoms at first, so you might be unaware you have it. You usually won’t have symptoms until your arteries become partially or completely blocked.  

Atherosclerosis can occur in any blood vessel, so it can affect many different organs. It can cause strokes when it occurs in your neck, and dementia when it occurs in your brain. Legs, kidneys, and even the penis are also often affected. 

It can be prevented. But if it’s left alone and gets worse, it can cause serious health problems which can be difficult to manage. These include:

• chest pain — angina
• heart attacks
• strokes 
• leg pain when walking — peripheral arterial disease
• temporary stroke symptoms — transient ischaemic attacks (TIAs)

Is atherosclerosis caused by cholesterol?

Experts used to think that having too much low-density lipoprotein (LDL) cholesterol in your blood was the main cause of atherosclerosis. LDL cholesterol is 1 of the 3 main types of cholesterol.

LDL is often referred to as “bad cholesterol”. But LDL helps to transport cholesterol to your cells — which is essential for your health. But, if the amount of LDL circulating in your blood is too high, it’s strongly liked to a higher risk of heart disease. LDL can be found in the plaque that clogs your arteries along with other substances, like immune cells, fibrous substances, and calcium.

It’s still thought that high cholesterol is connected to atherosclerosis. But experts believe it isn’t the only thing to blame.

More recent studies suggest it’s a combination of factors and their complex relationships with one another, including:

• environment — like diet, stress, and exercise
• drinking and smoking
• inflammation
• your immune system
• your cholesterol levels

Having a family history of heart disease can increase your risk too.

Is there treatment for atherosclerosis?

Atherosclerosis is difficult to treat — it’s easier to prevent in the first place. 

Healthy habits can help to reduce your risk, including:

• regular exercise — aim for 150 minutes moderate activity or 75 minutes of vigorous activity a week
• eating a diet full of fruit, vegetables, oily fish, nuts and seeds, and whole grains — like a Mediterranean diet 
• maintaining a healthy weight
• not drinking more than 14 units of alcohol a week
• stopping smoking — after a few weeks of no smoking, your inflammation levels become lower 
• limiting the amount of salt in your diet

Can you reverse atherosclerosis?

You can’t undo atherosclerosis, but there are medicines you can take to slow symptoms down.

These include: 

• medicines for high blood pressure
• medicine to reduce your risk of blood clots
• statins — medicines that reduce cholesterol
• medicines for diabetes
• surgery to widen or go around your affected artery

Maintaining healthy habits minimise your risk too. They prevent the things that cause atherosclerosis by improving your blood cholesterol, blood sugar, and blood pressure.