What Is Atherosclerosis?

Causes and Treatments

Having persistently elevated LDL cholesterol levels and triglycerides left untreated may lead up to a condition referred to as atherosclerosis. Also known as “hardening of the arteries,” atherosclerosis occurs when cholesterol and other lipids accumulate on the inner surfaces of the arteries. Although it has no symptoms, atherosclerosis can lead to a heart attack, a stroke, and even death. Keeping your lipid levels in check may help you to prevent or slow the progression of atherosclerosis.

What Happens During Atherosclerosis?

It is thought that some type of injury to the smooth, inner lining of your arteries is what starts the process of atherosclerosis. During atherosclerosis, excess cholesterol and other lipids circulating in the blood will bind to damaged areas of the inner lining of the affected artery, known as the endothelium. These lipids will enter into the area of the damaged vessel and deposit there. Inflammatory cells, like macrophages, will also enter the damaged area, causing inflammation and engulfing the lipids. As a result, the macrophages will often have a foamy appearance, earning them the name of “foam cell.” The beginnings of atherosclerosis can be noted as early as childhood or adolescence and is referred to as a “fatty streak”.

As the lipids begin to accumulate on the endothelial surface, a thick plaque will form. This plaque will thicken further eventually narrow the affected vessel, restricting blood flow.

When the vessel begins to narrow, this will begin to limit nutrients and oxygen to affected tissues and organs, which could include:

  • the brain (cerebrovascular disease)
  • the heart (coronary heart disease)
  • the kidneys (chronic kidney disease)
  • the extremities (peripheral vascular disease)

Not only can limited blood flow become a problem, the plaque can also become unstable and rupture.

This can completely occlude the vessel, cause platelets to attach and form a blood clot, or it can break off and travel to another part of the body and obstruct blood flow.

How Do I Know If I Have Atherosclerosis?

Just like with high cholesterol, there are no symptoms that can tell you that atherosclerosis is developing. In most cases, people aren’t even aware that they have atherosclerosis until they have their first heart attack or stroke. There are some things that you can do in order to detect whether you might be at risk for developing atherosclerosis, including:

  • Getting your lipids checked. Current guidelines from the American Heart Association suggest getting your lipids checked every 4 to 6 years of you are 20 years of age and older – even if you are healthy. Studies have shown that having high LDL levels and low HDL levels can increase your risk of developing atherosclerosis. Some studies are also showing that high triglyceride levels may also play a role in atherosclerosis, but this is still under investigation. High levels of certain lipid types, such as small dense LDL and lipoprotein(a), can also aid in the development of atherosclerosis.  
  • Getting your blood pressure checked. High blood pressure can be a risk factor for developing atherosclerosis because it can damage your arteries. Your blood pressure can be easily checked at home, at your doctor’s office, or at your local pharmacy or fire department.
  • Knowing your family health history. Having an early history of cardiovascular disease - including a heart attack or high cholesterol levels at an early age – could mean that your risk of developing atherosclerosis is higher.

Knowing your risk factors for developing atherosclerosis is also important. Not only does this include having high lipid levels, it can also include smoking, being overweight and having uncontrolled diabetes.

Atherosclerosis can be deadly if not addressed. Luckily, there are many things you can do now to prevent atherosclerosis from developing or slow its progression. Your healthcare provider can also prescribe treatments to help treat any medical conditions that could be placing you at risk for atherosclerosis - including high cholesterol and triglyceride levels.


Libby P. The Pathogenesis, Prevention, and Treatment of Atherosclerosis. In:Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. eds. Harrison's Principles of Internal Medicine, 19eNew York, NY: McGraw-Hill; 2015.

Lam JYT. Merck Manual of Diagnosis and Therapy. Accessed online: 24 February 2016.