Atherosclerosis happens when cholesterol, fats and other substances build up along the walls of your arteries, forming plaque that can harden and narrow these blood vessels over time. This buildup restricts blood flow, which means less oxygen-rich blood reaches your organs and tissues, increasing the risk of serious health problems.

This condition mainly affects the arteries that supply the heart, brain and limbs. As a result, it plays a major role in the development of heart disease, stroke and peripheral artery disease. Because atherosclerosis often develops slowly and without obvious symptoms, many people don’t realize they have it until it has already caused significant damage.

What Are the Types of Atherosclerosis?

Atherosclerosis is categorized by the location of plaque buildup, and each type can lead to different risks and symptoms. This underscores the importance of early detection and targeted treatment. Some of the most common types of atherosclerosis include:

Aortic Atherosclerosis

Aortic atherosclerosis is the gradual buildup of plaque in the aorta, the body’s main artery. Over time, this condition can weaken the artery wall, increasing the risk of aneurysms, arterial rupture, stroke or sudden loss of blood flow to vital organs and tissues. Aortic atherosclerosis often develops silently over many years, with most people experiencing no symptoms until it leads to a serious medical event.

Carotid Artery Disease

Plaque accumulation in the carotid arteries, which deliver blood to the brain, can restrict blood flow or cause a clot to travel to the brain. This can significantly increase the risk of stroke. Because this condition often develops without noticeable symptoms, regular screening is important for those at higher risk.

Coronary Artery Disease (CAD)

This type of atherosclerosis affects the arteries that supply blood to the heart muscle. As plaque narrows these arteries, it can cause angina, shortness of breath or heart attack. Early diagnosis and lifestyle changes can help manage symptoms and reduce the risk of severe complications.

Mesenteric Ischemia

Mesenteric ischemia occurs when atherosclerosis restricts blood flow to the intestines. Reduced blood supply can cause abdominal pain, especially after eating, and lead to weight loss or digestive issues over time. If left untreated, it can result in severe complications, including tissue damage in the intestines.

Peripheral Artery Disease (PAD)

This form of atherosclerosis occurs when plaque builds up in arteries that supply blood to the limbs, particularly the legs. PAD can cause leg pain when walking, numbness or tissue death in severe cases.

Renal Artery Stenosis

When the arteries supplying blood to the kidneys become narrowed due to atherosclerosis, it can reduce blood flow to the kidneys and impair function. This condition can lead to increased blood pressure and can even contribute to the development of chronic kidney disease over time.

What Are the Causes and Risk Factors of Atherosclerosis?

Atherosclerosis is a gradual, progressive condition that affects the arteries over time. While the exact causes are not fully understood, most experts agree that the process begins when the inner lining of the arteries become damaged. Once this damage occurs, cholesterol, fats and other substances can start to accumulate, leading to the formation of plaque and reduced blood flow. Some factors that can contribute to this damage include:

• Age – The risk of developing atherosclerosis increases with age as arteries naturally stiffen.
• Chronic inflammation or infections – Conditions such as bacterial infections (including endocarditis) may contribute to arterial damage.
• Elevated cholesterol and triglyceride levels – Excess fats in the blood can deposit in artery walls, making them narrower and less flexible. This restricts blood flow and increases the risk of blockages.
• Diabetes – High blood sugar levels can damage blood vessels over time.
• High blood pressure – Increased force against artery walls can also weaken them.
• Obesity or metabolic syndrome – Excess body weight, especially around the abdomen, increases the risk of insulin resistance, high cholesterol and inflammation, all of which promote atherosclerosis.
• Smoking – Chemicals in tobacco harm the endothelium, a thin tissue membrane lining the blood vessel, and accelerate plaque buildup.
• Unhealthy lifestyle habits – A poor diet high in saturated or trans fats, lack of physical activity and excessive alcohol consumption can all contribute to plaque buildup and damage to the arteries.

In addition to environmental and lifestyle factors, genetics can also play a role in atherosclerosis. A family history of cardiovascular disease can increase risk, especially when combined with other contributing factors.

What Are the Symptoms and Warning Signs of Atherosclerosis?

Atherosclerosis can range from mild to severe, with symptoms worsening as the disease progresses. In some individuals, especially in early stages, the condition remains asymptomatic until a serious event such as a heart attack or stroke occurs. However, as plaque gradually builds up and begins to narrow or block the arteries, symptoms start to appear, including:

• Chest pain or pressure, which is caused by reduced blood flow to the heart
• Shortness of breath, especially during exertion
• Fatigue due to decreased oxygen supply
• Pain in one or both legs while walking, which is a sign of peripheral artery disease
• High blood pressure if the kidney arteries are affected
• Sudden numbness or weakness, particularly in limbs
• Slurred speech or facial drooping, which can indicate a transient ischemic attack (TIA), also known as a mini stroke
• Temporary vision loss in one eye, which is linked to an issue with the carotid artery

Even if your symptoms seem mild or intermittent, it’s important to get medical attention. Early intervention can reduce the risk of serious complications. Get emergency care immediately if you experience sudden chest pain, fainting, severe dizziness, weakness or numbness on one side of the body or difficulty speaking or understanding speech. These may be signs of a heart attack or stroke.

Diagnosis & Tests for Atherosclerosis

Getting an accurate diagnosis is the first step in managing atherosclerosis and lowering your risk of complications. Because the symptoms of atherosclerosis can look similar to other conditions, it’s important to rule out issues like coronary artery spasm, pulmonary embolism, peripheral neuropathy, congestive heart failure and valvular heart disease.

Your doctor will start with a detailed medical history and a discussion about your symptoms. They will ask about:

• Your personal and family history of heart disease or stroke
• Lifestyle habits, including smoking, diet and physical activity
• Health conditions such as diabetes, high blood pressure or high cholesterol
• Any symptoms you’re experiencing, like chest pain, shortness of breath or leg pain when walking

During a physical exam, your doctor will also check for signs of poor circulation, including a weak pulse, slow-healing wounds or differences in blood pressure between your arms and legs. If atherosclerosis is suspected, your doctor may recommend tests to confirm the diagnosis and determine the location and severity of plaque buildup. These include:

• Blood tests to check cholesterol, triglyceride and blood sugar levels.
• Electrocardiogram (ECG) to look for irregular heart rhythms or signs of heart damage.
• Echocardiogram to assess how well your heart is pumping and blood flow patterns.
• Doppler ultrasound to check how well blood is flowing through your arteries and to detect any areas that may be narrowed or blocked.
• Ankle-brachial index (ABI) to measure and compare the blood pressure in your ankle and arm, which can help identify signs of peripheral artery disease.
• CT scan or coronary calcium scan to spot calcium deposits and gauge plaque buildup.
• Magnetic resonance angiography (MRA) or CT angiography to get detailed images of your blood vessels.
• Cardiac catheterization using dye and X-rays to view your coronary arteries and measure blood flow.

These tests help your doctor get a clear picture of your cardiovascular health and guide the next steps in your care plan.

How Do You Treat Atherosclerosis?

Treating atherosclerosis involves slowing the progression of the disease, relieving symptoms and reducing the risk of life-threatening complications like heart attack or stroke. A comprehensive treatment plan typically combines lifestyle changes, medications and surgical interventions in some cases. The goal is to restore healthy blood flow, protect organ function and support long-term cardiovascular health.

Medications to Manage Atherosclerosis

Medications play a key role in managing atherosclerosis by targeting the underlying causes of plaque buildup and improving overall heart health. Some commonly prescribed medications for atherosclerosis include:

• Antiplatelet medications – These drugs, such as aspirin, help prevent blood cells (platelets) from clumping together and forming clots. This reduces the risk of heart attacks and strokes caused by blocked arteries.
• Cholesterol-lowering medications – Statins and other lipid-lowering agents reduce levels of LDL (bad cholesterol) in the blood, helping to slow plaque buildup in the arteries.
• Blood pressure medications – Controlling high blood pressure reduces stress on artery walls, helping to prevent further damage and plaque accumulation. Common options include ACE inhibitors, beta-blockers, calcium channel blockers and diuretics.
• Anticoagulants – Also known as blood thinners, these medications decrease the blood’s ability to clot. This helps prevent dangerous blockages for individuals at high risk for stroke or with a history of blood clots.

Lifestyle Modifications for Atherosclerosis

Adopting heart-healthy lifestyle habits is key to managing life with atherosclerosis. A balanced diet rich in fruits, vegetables, whole grains, lean proteins and healthy fats helps lower cholesterol and blood pressure. Other important modifications include:

• Regular physical activity, at least 150 minutes per week, to support cardiovascular health and weight control.
• Quitting smoking and limiting alcohol intake to reduce artery damage and inflammation.
• Managing stress to help lower blood pressure and reduce strain on the heart.
• Monitoring blood pressure, cholesterol and blood sugar to ensure these levels stay within a healthy range.
• Maintaining a healthy weight to reduce the strain on your heart and lower your risk of additional health complications.

Surgical and Interventional Procedures to Treat Atherosclerosis

When lifestyle changes and medications are not enough to manage severe cases of atherosclerosis, interventional procedures might be needed to restore proper blood flow. These include:

• Coronary angioplasty and stenting – A catheter is inserted into the narrowed artery, and a small balloon is inflated to open it up. Often, a stent (a tiny wire mesh tube) is left in place to keep the artery open.
• Coronary artery bypass grafting (CABG) – In this procedure, a healthy blood vessel is taken from another part of the body and grafted around the blocked artery to reroute blood flow.

These procedures are typically performed by interventional cardiologists.

What Are the Complications and Long-Term Effects of Atherosclerosis?

If left untreated, atherosclerosis can lead to serious and potentially life-threatening complications. As plaque builds up and arteries narrow, blood flow to vital organs is restricted, increasing the risk of both sudden events and chronic health problems. As a result, the following complications can develop, significantly impacting overall health and quality of life, and in some cases, leading to permanent damage or death.

• Heart attack – Caused by complete blockage of a coronary artery
• Stroke – Resulting from reduced or blocked blood flow to the brain
• Peripheral artery disease (PAD) – Leading to leg pain, poor wound healing, or even limb loss
• Aneurysms – Bulging and weakening of arterial walls, which can rupture
• Chronic kidney disease – When arteries supplying the kidneys become narrowed or blocked
• Blood clots – Which can dislodge and cause embolism elsewhere in the body

Beyond acute emergencies, atherosclerosis can lead to long-term health challenges that require continuous management, including chronic chest pain (angina), reduced mobility from leg pain or fatigue, ongoing high blood pressure, and increased risk of cognitive decline due to impaired brain circulation.

How Do You Prevent and Reduce Your Risk of Atherosclerosis?

You can take steps to protect your heart and arteries long before problems start or to help prevent existing issues from getting worse. Healthy habits like eating a balanced diet, staying active and quitting smoking play a big role in keeping your arteries clear. Regular check-ups are just as important, as they can catch high cholesterol, high blood pressure or early signs of artery damage before you even notice any symptoms.

Talk to your healthcare provider about:

• Getting your blood pressure and cholesterol checked regularly
• Monitoring your blood sugar, especially if you have diabetes or are at risk
• Imaging tests like carotid ultrasound or coronary calcium scans to check for early plaque buildup
• An ankle-brachial index (ABI) test to screen for peripheral artery disease

It’s also important to stay up to date on vaccines like the flu and pneumonia shots if you have heart conditions since infections can put extra strain on your heart.

The TGH Difference for Atherosclerosis

Atherosclerosis is a progressive condition where plaque builds up in the arteries, leading to restricted blood flow and increased risk of serious heart attack, stroke, kidney disease and other complications. The condition can develop silently over time making detection and intervention essential to prevent long-term damage.

If you or a loved one are at risk for atherosclerosis, it's important to consult a healthcare provider. Personalized care, regular screenings and proactive management make a significant difference in your long-term heart health. Early evaluation by a specialist also helps you understand your risk, explore treatment options and create a plan tailored to your needs.

At Tampa General Hospital’s Heart & Vascular Institute, we offer comprehensive cardiovascular care through world-class facilities, leading specialists and a patient-first approach. We bring together expert cardiologists, vascular surgeons and interventional radiologists to diagnose and treat a wide range of arterial conditions, including atherosclerosis. Our patients benefit from:

• A reputation as one of the Nation's Best Hospitals for Heart & Vascular Care by U.S. News & World Report for 2025-2026
• Tampa Bay’s first and only Level 1 Heart Attack Center
• Access to advanced diagnostic tools, minimally invasive procedures and leading-edge research
• A multidisciplinary team offering personalized care plans for each patient

With the TGH team by your side, you’re not just managing a condition, you’re gaining a partner in lifelong cardiovascular health. Call (813) 844-3900 or email us at heart-vascular@tgh.org to schedule an appointment.