Skip to main content


Medically reviewed by Last updated on Mar 18, 2023.

What is atherosclerosis?

Harvard Health Publishing

Atherosclerosis is the process of cholesterol plaque buildup in arteries. It can lead to a narrowing of the arteries that can significantly reduce the blood supply to vital organs such as the heart, brain, and intestines. In atherosclerosis, the arteries are narrowed when fatty deposits called plaques build up inside. Plaques typically contain cholesterol from low-density lipoproteins (LDL), smooth-muscle cells and fibrous tissue, and sometimes calcium.

As a plaque grows along the lining of an artery, it can sometimes rupture, leading to formation of a blood clot inside the artery, which can totally block blood flow. As a result, the organ supplied by the blocked artery starves for blood and oxygen. The organ's cells may either die or suffer severe damage.

Atherosclerosis is the main cause of death and disability in industrialized nations, including the United States. This is because atherosclerosis is the underlying medical problem in most patients with any of the following illnesses:

Factors that increase your risk of developing atherosclerosis include:

Symptoms of atherosclerosis

Atherosclerosis usually doesn't cause any symptoms until blood supply to an organ is reduced. When this happens, symptoms vary, depending on the specific organ involved:

Diagnosing atherosclerosis

Your doctor will review your medical history, your current symptoms and any medications you are taking.

Your doctor will ask you about your family history of heart disease, stroke and other circulatory problems, and your family history of high blood cholesterol. He or she will ask about cigarette smoking, your diet, and how much exercise you get.

Your doctor will measure your blood pressure and heart rate. He or she will examine you, paying special attention to your circulation, sometimes listening to the arteries in the neck. The exam includes feeling for pulses in your neck, wrists, groin, and feet. Your doctor may check the blood pressure in your legs, to compare it to the pressure in your arms. The ratio of your blood pressure at your ankle to the blood pressure inside your elbow is called an ankle-brachial index or ABI.

Signs of poor impaired circulation include:

Your doctor will order blood tests to measure your total, LDL and HDL cholesterol levels, triglyceride level, fasting blood sugar, hemoglobin A1c (a measure of blood sugars over the prior three months), and sometimes hs-CRP C-reactive protein, a marker for inflammation), and Lp(a) (lipoprotein(a), a fatty particle linked to a heightened risk of heart attack). A routine electrocardiogram (EKG) occasionally will uncover electrical changes in the heart that indicate poor blood flow to the heart muscle. Your doctor may order an EKG performed during an exercise stress test if you have any symptoms suggestive of coronary artery disease.

Imaging tests such as CT scans or MRIs can sometimes be done (or reviewed if already done for a different reason). They can reveal calcium buildup (a sign of atherosclerosis) in arteries of the heart, the aorta, carotid arteries to the brain, or in the abdomen. A calcium score test is a CT scan of the heart to look for this buildup in the heart arteries. A carotid ultrasound is an ultrasound looking for cholesterol plaque or blockage in the arteries to the brain.

Treatment options

The following list of medications are in some way related to or used in the treatment of this condition.

Expected duration of atherosclerosis

Atherosclerosis is a long-term condition that continues to worsen over many decades without changes in lifestyle and medication if necessary.

Preventing atherosclerosis

You can help to prevent atherosclerosis by changing your risk factors for the illness. You should practice a lifestyle that promotes good circulation and combats atherosclerosis:

Treating atherosclerosis

There is no cure for atherosclerosis, but treatment can slow or halt the worsening of the disease. The major treatment goal is to prevent significant narrowing of the arteries so that symptoms never develop and vital organs are never damaged. To do this, you would begin by following the healthy lifestyle outlined above.

If you have high cholesterol that cannot be controlled by diet and exercise, your doctor will likely recommend medication. The most common medicines used to lower cholesterol are statin drugs, also known as HMG-CoA reductase inhibitors. Statins block an enzyme called HMG-CoA reductase, which controls the production of cholesterol in the liver. Examples include:

Many other non-statin classes of medication exist as well. These medications have been shown to reduce risk of heart events. they include:

Anti-clotting medications such as aspirin, or other antiplatelet drugs such as clopidogrel (Plavix), are often used as well. They can increase the risk of bleeding, so careful selection of which agent and for how long is needed.

Once symptoms of atherosclerosis-related organ damage develop, the specific treatment depends on the organ involved:

When to call a professional

It is possible to have atherosclerosis for many years without having symptoms. If you experience symptoms of an atherosclerosis-related medical condition, contact a doctor immediately.


Atherosclerosis leads to the number one cause of death in the United States and many other countries: cardiovascular disease. However, people with atherosclerosis are living longer with better quality of life than ever before. For many, this is disease can be prevented. Even those people genetically programmed for atherosclerosis can delay the beginning and worsening of the disease with a healthy lifestyle, the right foods, and medication to lower LDL cholesterol.

Additional info

National Heart, Lung, and Blood Institute (NHLBI)

American Heart Association (AHA)

American College of Cardiology

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.