Knowing your personal risk can help you make changes that may help
The potential risks of atherosclerosis—such as heart disease, heart attack, and stroke—are some of the top 10 leading causes of death in the United States. For this reason, it’s important to understand what causes the hardening of the arteries. Knowing the risk factors of atherosclerosis can empower you to make the choices to prevent it.
“Atherosclerosis is a progression over many years,” says Lawrence Phillips, MD, cardiologist at NYU Langone Health. “Even if somebody is told at some stage that they have atherosclerosis or narrowing of their blood vessels, it doesn't mean that they're going to have an event, like a heart attack or a stroke. Instead, it's a wake-up call that you need to modify your risk even further.”
When levels of LDL (“bad”) cholesterol in the body are too high, it can form plaque. Plaque builds up on the walls of blood vessels, which can cause the wall to thicken. As a result, this plaque buildup may narrow the channel and reduce blood flow.
This process of hardening arteries is called atherosclerosis (pronounced “ath-er-oh-skluh-ROH-sis”). Even when it’s mild, the reduced blood flow can limit the oxygen and nutrients that the rest of the body needs.
When atherosclerosis becomes severe, however, plaque may block arteries to the organs. For example, a blocked artery to the heart can result in angina, or chest pain from reduced blood flow. Worse, if a piece of brittle plaque breaks off and gets stuck, it may lead to a heart attack or stroke.
Causes of Atherosclerosis
There’s no single cause of atherosclerosis: A variety of factors may increase your risk. “When we think about risk factors for atherosclerosis we're thinking in two categories: one being modifiable and those that are non-modifiable,” says Dr. Phillips.
“The non-modifiable [risk factors] will be your age, your gender, and your ethnicity,” says Dr. Phillips. Because atherosclerosis progresses as you age, it’s more common the older you get.
As for modifiable risk factors, the chances of atherosclerosis are higher if you:
- Have high cholesterol or high triglycerides
- Smoke cigarettes
- Have high blood pressure
- Are overweight or inactive
- Have diabetes
- Eat an unhealthy diet, such as a diet high in saturated fat
“It's important that everybody know their risk for developing atherosclerosis because the outcome can be a heart attack, a stroke, or even death. We know that atherosclerosis can be delayed and stopped from progressing by knowing your numbers and modifying your risk,” says Dr. Phillips.
Lawrence Phillips, MD, is a cardiologist at NYU Langone Health. Dr. Phillips is the assistant professor of the Department of Medicine at NYU Grossman School of Medicine, the assistant clinical director for strategic affairs at Leon H. Charney Division of Cardiology, the director of the Nuclear Cardiology Laboratory, the medical director for Outpatient Clinical Cardiology, and the associate director of the Cardiovascular Disease Fellowship Program.
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So atherosclerosis is a narrowing
of the arteries in the body.
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They could be narrowing in the arteries to the heart,
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to the kidneys, to the legs, to the brain,
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but overall, you're looking at deposits
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of outside material into the blood vessel walls.
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The narrowing is being caused by
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kind of filling in the walls.
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It can occur early in teen years
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and progress over years 'til older age.
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The material that gets put into the walls
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fat, the body's immune cells,
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as well as other materials like fibrin.
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By depositing material into the blood vessel walls,
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it causes narrowing.
It's kind of like overstuffing a suitcase,
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and as you put more and more into the walls
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of the vessel, you end up having,
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first, the vessel push out, but then narrow,
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restricting blood flow, causing disease.
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When we think about risk factors for atherosclerosis,
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we're thinking in two categories, one being modifiable,
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and those that are non-modifiable.
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So the non-modifiable ones will be your age,
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your gender, your ethnicity.
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The modifiable ones are your blood pressure,
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obesity and being overweight,
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and sedentary lifestyles,
as well as your diet.
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So one of the problems with attacking atherosclerosis
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is you might not have any symptoms.
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What you need to do is, first, know your numbers,
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and second, learn how to modify your risk.
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So since most patients are asymptomatic
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when they're developing the atherosclerosis,
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having routine follow-up with a physician is very important.
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It's important that everybody know their risk
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for developing atherosclerosis because the outcome
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can be a heart attack, a stroke, or even death.
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So atherosclerosis is a progression over many years.
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Most people don't know that atherosclerosis actually starts
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in your teenage years, and it's the progression
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over your lifetime which causes you problems.
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So even if somebody is told at some stage that they have
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atherosclerosis or narrowing of their blood vessels,
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it doesn't mean that they're going to have an event
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like a heart attack or a stroke.
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Instead, it's a wake-up call
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they need to modify your risk even further.
- Atherosclerosis. Bethesda, MD: National Herat, Lung, and Blood Institute. (September, 17, 2020)
- Atherosclerosis. Dallas, TX: American Heart Association. (Accessed on September 17, 2020)
- High cholesterol facts. Atlanta, GA: Centers for Disease Control and Prevention, 2020. (Accessed on September 21, 2020)
- Pathogenesis of atherosclerosis. Waltham, MA: UpToDate, 2020. (Accessed on September 17, 2020)