Atherosclerosis is a common condition that affects millions of people around the world and is one of the leading causes of heart attacks and strokes.
It develops slowly over many years and often causes no symptoms until a serious health problem occurs. Understanding how atherosclerosis develops and what increases the risk can help people take steps to protect their heart and blood vessels.
Arteries are blood vessels that carry oxygen-rich blood from the heart to the rest of the body. Healthy arteries are flexible and allow blood to flow smoothly.
However, in atherosclerosis, the inner walls of the arteries gradually become thicker and harder because of a buildup of plaque. As plaque grows, the arteries become narrower, reducing blood flow to important organs and tissues.
Plaque is a sticky substance made up of cholesterol, fat, calcium, inflammatory cells, and other materials found in the blood. At first, plaque deposits may be small, but over time they can grow larger and harder.
In some cases, plaque can suddenly rupture, causing a blood clot to form. If the clot blocks blood flow to the heart, it can cause a heart attack. If it blocks blood flow to the brain, it can cause a stroke.
One of the most important causes of atherosclerosis is high cholesterol. Cholesterol is a waxy substance that the body needs to build cells and produce certain hormones. However, having too much cholesterol in the bloodstream can become a problem.
Low-density lipoprotein, commonly known as LDL cholesterol, is often called “bad” cholesterol because it contributes to plaque formation.
High-density lipoprotein, or HDL cholesterol, is often called “good” cholesterol because it helps remove excess cholesterol from the blood. When LDL levels are high and HDL levels are low, the risk of plaque buildup increases significantly.
High blood pressure is another major risk factor. Blood pressure is the force of blood pushing against artery walls. When blood pressure remains high for many years, it can damage the delicate inner lining of the arteries.
This damage creates areas where cholesterol and other substances can collect more easily, encouraging plaque formation. High blood pressure also makes arteries less flexible, which further increases the risk of cardiovascular disease.
Smoking is one of the most harmful habits for artery health. Tobacco smoke contains thousands of chemicals that damage blood vessels and promote inflammation. Smoking lowers HDL cholesterol levels, increases blood pressure, and makes blood more likely to clot.
Together, these effects greatly increase the risk of atherosclerosis. The good news is that quitting smoking can quickly begin to improve blood vessel health and reduce future risk.
Diabetes, especially type 2 diabetes, is also strongly linked to atherosclerosis. When blood sugar levels remain high over long periods, blood vessels can become damaged.
High blood sugar can also increase inflammation and make it easier for plaque to form. Many people with diabetes also have high blood pressure, obesity, or abnormal cholesterol levels, which further increase their risk of artery disease.
Lifestyle choices play a major role as well. Physical inactivity can contribute to weight gain, high blood pressure, poor cholesterol levels, and insulin resistance.
Regular exercise helps improve circulation, lower blood pressure, increase good cholesterol, and maintain a healthy weight. Even simple activities such as walking, cycling, gardening, or swimming can provide important benefits for heart health.
Diet also has a powerful influence on artery health. Eating large amounts of fried foods, processed foods, sugary drinks, and foods high in unhealthy fats may increase cholesterol levels and contribute to plaque buildup.
In contrast, diets rich in fruits, vegetables, whole grains, nuts, legumes, and lean protein sources provide nutrients that support healthy blood vessels. Many studies have shown that healthy eating patterns can reduce the risk of cardiovascular disease.
Genetics can also affect a person’s risk. People with a family history of heart disease may be more likely to develop atherosclerosis, even if they maintain a healthy lifestyle. Certain inherited conditions can cause very high cholesterol levels from a young age, increasing the risk of early artery disease.
Although genes cannot be changed, knowing about family history allows people to work with healthcare providers to monitor and manage their risk more effectively.
Age is another factor. As people get older, the chances of developing plaque buildup increase. This is partly because the effects of risk factors such as high cholesterol and high blood pressure accumulate over time. Men generally develop atherosclerosis earlier than women, although women’s risk rises after menopause.
The encouraging news is that many of the major causes of atherosclerosis can be controlled. Managing cholesterol levels, keeping blood pressure within a healthy range, avoiding smoking, controlling diabetes, staying active, maintaining a healthy weight, and eating a balanced diet can all help slow or prevent plaque buildup.
Regular medical checkups can also identify problems early, allowing treatment to begin before serious complications develop.
Scientists continue to study atherosclerosis to better understand how plaque forms and how it can be prevented or reversed. Advances in treatment and prevention have already saved many lives, and ongoing research may lead to even better ways to protect people from heart attacks and strokes in the future.
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